Mental Health Bill [Lords]

Edward Argar Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Edward Argar (Melton and Syston) (Con)]

I thank the Secretary of State for bringing the Bill before Parliament. The last update to the Mental Health Act, in 2007, took eight years following the Richardson review, and this Bill has been a similarly long time in the making, so I welcome the speed with which he has moved on it since taking office. Although we may tussle on occasion, as I have said since the election, we on the Conservative Benches will not oppose for the sake of opposition. We will be constructive, working to improve legislation and supporting the Government where we believe they are doing the right thing, and I recognise the Secretary of State’s constructive approach to the Bill.

At the outset, let me join the Secretary of State in paying tribute to the families of Calocane’s victims in Nottingham for what they have done subsequently—their campaigning, their dedication and their work, including on this legislation—and for the incredible dignity with which they have conducted themselves in unthinkable circumstances.

As the Secretary of State mentioned, the Mental Health Act 1983—I will not miss the opportunity to allude to his youthfulness—governs the compulsory detention and medical treatment of people with severe mental illness for the safety and protection of themselves and those around them. He also set out that sadly, all too often, those with learning disabilities or autism have been conflated with that group. We must take this opportunity to address that, and the Bill rightly seeks to do so. In the more than 40 years that have followed the 1983 Act, healthcare, treatments and, crucially, our understanding of mental health illnesses have come on in enormous strides. It is not only important but right that our laws are updated to reflect the modern world and the knowledge that we have today.

We are debating measures that impact those with the most severe mental health issues and their families, but as was highlighted in interventions on the Secretary of State, we should not forget the broader context, the challenges posed by mental health issues more broadly, or the importance of continued investment in this space. We should also recognise the many organisations that do amazing work both to educate society about mental ill health and to support people with mental health illnesses.

Let me take this opportunity to pay tribute to my right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt), who has just left the Chamber, for the work that he did on mental health as Secretary of State. I think it is fair to say that, away from the to and fro of party politics, the current Secretary of State shares my right hon. Friend’s passion and determination to address these issues. As he said, we have done much, but I believe we can and must continue to strive to do better.

Keeping legislation up to date is particularly important for a measure such as the Mental Health Act, which gives the state the power to deprive people of their liberties in order to protect the safety of the individual and those around them and to carry out treatment. Those powers should only ever be used when absolutely necessary, and it is therefore right that they are reviewed and updated to ensure that they remain relevant, proportionate and appropriate.

The most recent update to the Mental Health Act, in 2007 under the last Labour Government, introduced community treatment orders and independent mental health advocates and changed the detention criteria. Since then, as the Secretary of State alluded to, trends have emerged that have raised concerns. The overall number of detentions under the Act has been rising steadily. There were around 52,500 recorded detentions in England in 2023-24, including 963 of children aged 17 and under. That is a 2.5% increase on the previous year and around 14% higher than in 2016-17. In the same year, 2023-24, black people were 3.5 times more likely than white people to be detained under the Act, and seven times more likely to be placed on a community treatment order. The reasons for that are likely to be complex, and I will return to them later.

That is why in 2017, just 10 years after the previous update, the then Prime Minister, Theresa May—now Baroness May—commissioned an independent review of how the Mental Health Act was used and how it could be improved. The review considered not only the trends in detentions, but wider concerns about whether some processes were out of step with what should exist in a modern mental health system, including the balance of safeguards, patient choice and patients’ agency in their own care, and the effectiveness of community treatment orders. Sir Simon Wessely published the report of his review in 2018, and I take this opportunity to put on the record again our thanks for his important work.

[Wes Streeting]

Hear, hear.

[Edward Argar]

The previous Government published a draft Mental Health Bill based on the recommendations in the report, giving others the opportunity to have their say. The draft Bill was subject to pre-legislative scrutiny by a Joint Committee of Parliament, allowing Members of both Houses to thoroughly review it and make recommendations before the final version was introduced.

Given the importance of this area of policy, which can have such a profound impact on people’s lives, I believe it is right that we took the time to get this right. The work to update the Mental Health Act started under the previous Government and we had a commitment in our election manifesto to update the law in this area, and that has been carried on by the new Government. We continue to believe that this is the right thing to do, so I put on the record our in-principle support for the Government on the Bill.

I pay tribute to my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) for his work in this space as a shadow Minister. Not only does he have professional expertise, but he has brought it to the House’s deliberations on this legislation. I suspect that we may hear from him a little later.

There are many areas of the Bill that we welcome, including the strengthening of the patient’s right to express a treatment preference, the expansion of access to independent mental health advocates, and the removal of police and prison cells as places of safety so that patients can be treated in an appropriate setting. That said, of course we will not stand back without scrutinising and seeking constructively to improve the Bill as it passes through the House. Part of our role as the Opposition is to engage constructively in the scrutiny of legislation—to ask questions, to probe further, to seek to prevent unintended consequences, and to identify potential problems and ensure that they are aired in Committee—in order to improve it for everyone’s benefit, and that is what we shall do. I know that my hon. Friend the Member for Hinckley and Bosworth (Dr Evans) will approach the Public Bill Committee in that vein.

We very much welcome efforts to improve patients’ voice and involvement in their own care, including through greater use of advance choice documents. In its current form, the Bill places a duty on NHS England and integrated care boards to make patients aware of their option to have such a document, but this could be as simple as having a poster on a noticeboard, for instance. It does not necessarily require a conversation. Introducing it as a legal right for patients who are being treated or for someone who is at risk of detention would mean that they have to be specifically told about the option, allowing them to make a deliberate decision. I suspect that in Committee we may gently press the Minister to go further in strengthening the patient’s right to have their voice heard. I have been on a number of Bill Committees, and gently hinting to the Minister areas where we might press further may make his and his officials’ lives a little easier when amendments are tabled in Committee.

We were pleased that peers passed an amendment to better protect children who require a nominated person, removing the discretion where a court order regarding parental responsibility is in place. However, we believe there is more we can do to support and protect children, particularly regarding age-appropriate settings for treatment. I hope that when the Minister for Care winds up, or in Committee, he will explore in greater detail the steps the Government are taking to reduce the number of children being treated on adult mental health wards and to ensure that lessons are learned at both national and local service provider level.

Thirdly, we are conscious that a number of elements of the Bill will require additional resources to be put in place. The removal of police and prison cells—sensibly—as places of safety will require sufficient alternative capacity for people to be treated when they are detained. What approach do the Government intend to take in addressing this?

Increasing the frequency with which patients can apply to the mental health tribunal to have their detention reviewed and widening automatic referrals will potentially increase demand and pressure on the system. We know that the legal system is already under pressure, and the impact assessment acknowledges that there will be impacts and costs, so is the Minister confident that the system has the capacity to handle the additional demands? If not, what steps are being taken with the Ministry of Justice to address that?

[Iqbal Mohamed]

The shadow Secretary of State raises an important point about resources. The updated impact assessment estimates that the cost of reform is £5.3 billion. With the Secretary of State having confirmed that mental health spending is falling as a share of NHS expenditure from 9.01% to 8.73%, does the shadow Secretary of State agree that without legislative safeguards to protect mental health funding, the Bill may not achieve the aims it sets out to achieve?

[Edward Argar]

The hon. Gentleman is right to highlight both the costs and the investment that is needed, but the cost does not detract from the importance of and need for the measures set out in the legislation. He points out that as a proportion of overall health spending, mental health spending has fallen slightly in the latest figures. I hope that the Minister in his wind-up will address how the Government will ensure that this legislation, which enjoys broad support across the House, has the resources behind it to deliver the outcomes we all wish to see in practice?

[Wes Streeting]

Will the right hon. Member give way?

[Edward Argar]

I will regret doing so, but of course I give way to the Secretary of State.

[Wes Streeting]

I should point out for the record that mental health spending has increased in real terms this year, thanks to the decisions the Government have taken. As a proportion of spend on health services overall, it is true to say that it has decreased by 0.07%, but that does not take into account the fact that as well as investing heavily in our elective backlog and in clearing waiting lists, we are investing in general practice, which will benefit enormously people with mental ill health.

[Edward Argar]

The Secretary of State was kinder than he normally is, and I am grateful to him for acknowledging the reduction in the proportion of mental health spending—it is slight, but it is none the less a reduction. I hear what he says more broadly, but I hope that he and the Minister will reiterate their commitment to ensuring that the legislation succeeds, which we all wish for, and that the pressures it may place on parts of the system will be addressed and not simply be absorbed within the system. I suspect that the Minister will come to that in his concluding remarks.

While it is the right principle to direct more mental health patients away from in-patient hospital settings and to community treatment settings where clinically appropriate—this is key, and goes to the Secretary of State’s point—we must ensure that the NHS has the capacity to provide community treatments when the Bill is on the statute book. The Government accepted that the reforms will take a number of years to implement, given the need to recruit and train more clinical and judicial staff, but what is the plan and how much will it cost? Will it be phased in over a number of years?

The NHS workforce plan will nearly double the number of mental health nurses by 2031-32, but the Secretary of State has said that he intends to update the plan. It would be helpful if, during the Bill’s passage, he or the Minister could tell either the Bill Committee or this Chamber what the changes that he envisages making through this legislation will mean for the workforce.

We recognise the significance of the provisions limiting the detention of patients with a learning disability or autism. Under the Bill, they can be detained for treatment only if they have a co-occurring mental health condition that requires hospital treatment and meet the criteria in the Mental Health Act 1983. Autism alone would no longer justify continued detention under the 1983 Act; in theory, this will ensure that those with autism receive the appropriate support in the right setting, as we would all wish. What steps are being taken to ensure that there are sufficient services, with sufficient capacity, to properly support people with autism and learning disabilities? Can he confirm that under this legislation, there will always be a central role for professional clinical judgments on these matters?

This debate in part follows on from concerns being raised about racial disparities in the application of the Mental Health Act. Can the Secretary of State or the Minister provide more evidence to help the House better understand this issue? What research has been undertaken, or is being planned, to enable us to understand what is behind the statistics?

We welcome this important opportunity to look again at how we treat and protect people with the most severe mental illnesses, and to ensure that our laws remain relevant and proportionate in the modern world, empowering people and treating them humanely. Updating the Mental Health Act is the right thing to do, and we will work constructively with the Government to improve the safety, treatment, agency and, crucially, dignity of mental health patients who are detained, and of the wider public.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 6th May 2025 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

I fear that many will have found the Minister’s answer to my hon. Friend the Member for Windsor (Jack Rankin) disappointing. He highlighted that the previous Government committed to the headline recommendation of the cross-party birth trauma inquiry led by the hon. Member for Canterbury (Rosie Duffield) and the former Member for Stafford, Theo Clarke, who has recently written about her experiences in a book, and in the Daily Mail called for a national maternity improvement strategy. No equivalent commitment has been made by this Government. Let us try again: will the Minister commit without any equivocation to implementing the inquiry’s recommendation to produce a national maternity improvement strategy?

[Karin Smyth]

To be clear for the shadow Secretary of State, the Secretary of State is continuing to look at all those recommendations and consider how best to respond.

--- Later in debate ---

[Mr Speaker]

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

The Health Service Journal reports that officials have acknowledged that the first draft of a high-level plan for merging NHS England and DHSC has been delayed. When we ask any written question about the merger, the standard answer seems to be:

“Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to determine the structure and requirements needed to support the creation of a new centre for health and care.”

Even when we ask a question specifically about the size of the transformation team, the answer is virtually identical. The Government either wilfully decide not to answer, or simply do not know. As with so many things, the Government go for the headline-grabbing announcement and talk the talk on reform, without having done the actual work to deliver it. My question to the Secretary of State is simple: when will that first high-level plan for the merger, with a full assessment of costs and savings, be published?

[Wes Streeting]

Honestly, the right hon. Member had his chance—he was the Minister who took forward the last reform Act, under the Conservative Government. He failed in that task, and now he turns up without a shred of remorse or a shred of humility, attacking this Government for cleaning up the mess that the Conservatives left behind. They are not a party of government—they are not even a party of opposition any more. They are a total irrelevance.

Tobacco and Vapes Bill

Edward Argar Excerpts

Report stage
Wednesday 26th March 2025 Commons Chamber

[Edward Argar (Melton and Syston) (Con)]

I am conscious of time, so I will be brief. I recognise the sincerely and strongly held views on both sides of the debate, which has played out with courtesy in this Chamber and in Committee, where Members have shown respect for one another and for differing views. I want to put on record my gratitude to all right hon. and hon. Members who have spoken. I congratulate the Minister on being thrown in at the deep end and taking through a piece of legislation with courtesy, very swiftly after she was appointed.

I thank the Clerks, the Whips and those who served on the Bill Committee. I do want to single out the phenomenal work done by the shadow Minister, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), and her staff, Angus Forbes-Cable and Joey Ricciardiello, who did so much on the Bill, especially in Committee. As ever, even though there are strong feelings on both sides, the House has shown itself able to grapple with difficult issues with courtesy and thoughtfulness.

Question put, That the Bill be now read the Third time.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 25th March 2025 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

May I take this opportunity to thank the Secretary of State for his kindness following the death of my father earlier this month? It was very much appreciated.

I welcome the moves to streamline decision making and improve efficiency in the context of the Secretary of State’s NHS England announcement, if he genuinely drives decentralisation to integrated care boards. However, in a written answer on 21 March, the Minister for Secondary Care said:

“We recognise there may be some short-term upfront costs as we undertake the integration of NHS England and the Department”.

For clarity, can the Secretary of State confirm what the quantum of those reorganisation costs will be and the date by which they will have been recouped?

[Wes Streeting]

I am sure that the whole House will want to send our condolences to the right hon. Gentleman following the loss of his father. It is good to see him back in action—if not always back in action.

Given the scale of the job reductions and savings that we are seeking to make, the total quantum will be determined once the final shape of the organisation is determined.

[Edward Argar]

Can I also welcome, as I did in January, the Secretary of State’s commitment to seek to work cross party on the future of social care? He was right and I welcomed that at the time, but like him and many others, we are all keen to see progress. Can he update the House on when he anticipates the cross-party talks that were postponed in February will be rescheduled to take place?

[Wes Streeting]

Baroness Casey will be making contact with all party groups in order to set dates with parties across this House very shortly, and of course she will be kicking off her commission in April, which is now only days away.

Rare Cancers Bill

Edward Argar Excerpts

2nd reading
Friday 14th March 2025 Commons Chamber

[Edward Argar (Melton and Syston) (Con)]

May I start by extending to the hon. Member for Cumbernauld and Kirkintilloch (Katrina Murray) and her family my sincere condolences on the passing of her father?

This is an important Bill. I often say to constituents, “If you wish to see the House of Commons at its best, tune in and watch on a Friday.” I say that again today, having heard the debate. It is it is rare for a shadow Secretary of State to take to the Front Bench on a Friday to respond on a private Member’s Bill, but the debate has reinforced my determination to be here.

As the hon. Member for Bootle (Peter Dowd) said—I like to call him my hon. Friend—this is a Bill of hope. I pay tribute to the hon. Member for Edinburgh South West (Dr Arthur) for his clear and compelling articulation of the case for the Bill, and for being willing to share something as personal as the loss of his father-in-law and his family’s circumstances. He spoke about that with great dignity.

With a debate of such quality, it is always invidious to pick out contributions, but I cannot resist doing so. I have to pick up the contribution of the hon. Member for Mitcham and Morden (Dame Siobhain McDonagh). When I was a Minister, we often worked with each other and spoke on matters relating to health, although not this subject. Her passion, determination and energy for change and for something better comes across in everything she does, and that builds on the fact that this is a Bill for hope. I pay tribute to her for her work and her dedication.

I have been a Member of this House for 10 years, and before the election I was a Minister for six. Two and a half of those years were spent as a Minister in the Department of Health and Social Care during the pandemic, in times that were challenging for everyone, but I have to say that I have rarely heard a speech as powerful and moving, or that held the House so completely, as that of the hon. Member for Calder Valley (Josh Fenton-Glynn). Although I did not know his brother, I suspect that he would have been deeply proud of the hon. Member today.

“Rare” in this context is often a misnomer, because although individually these cancers are rare, collectively they are sadly all too prevalent. As we have heard from hon. Members, approximately 55% of all cancer deaths are down to so-called rare cancers. The breadth of those rare cancers is huge: they include blood cancers, cancers of the female reproductive organs, head and neck cancers, pancreatic cancer, brain cancer—the hon. Member for Mitcham and Morden spoke about glioblastomas—and, importantly, children and young people’s cancers, which the hon. Member for Esher and Walton (Monica Harding) spoke about.

We have all seen the amazing work by powerful campaigners on these issues and by the huge array of charities campaigning in this space: Cancer52, the Brain Tumour Charity, the Tessa Jowell Brain Cancer Mission, Leukaemia UK, Pancreatic Cancer UK and a whole range of other dedicated and amazing institutions. They do a fantastic job. Like other hon. Members, I recently met Pancreatic Cancer UK to hear about its work; the hon. Member for Birmingham Erdington (Paulette Hamilton) may well have done the same. Initially, it was to discuss pancreatic enzyme replacement therapy drug shortages and the urgent need for some sort of solution, but we also had the opportunity to talk more broadly about pancreatic cancer and rare cancers.

Pancreatic Cancer UK highlighted issues that are specific to pancreatic cancer but that I suspect are reflective of many rare cancers: the challenge of diagnosis, the challenges posed by late diagnosis, the reliance on a single therapeutic or a small number of therapeutics with complex supply chains, and the challenges of clinical trials. Sadly, so few people with pancreatic cancer, even when they are able to enlist on such trials, survive long enough to provide the data that will make a real difference. The Bill will help to address that.

Because each rare cancer is different, each rare cancer needs focused research and treatment. The hon. Member for Bootle set out clearly the orphan drugs regime for rare cancers. Yes, there are incentives; under the 2021 regulations it is possible to incentivise pharmaceutical companies that may not be inclined to invest in research in areas that may benefit only a few, in comparison with the large numbers affected by other cancers. The regime seeks to give market exclusivity rights for 10 years, helping to reduce the costs of market authorisation, but we have to ask the question that the Bill asks: is it actually doing the job it needs to do to genuinely incentivise companies to invest in research in this space?

The hon. Member for Mitcham and Morden mentioned the NHS repurposing project. If we make it work effectively, it will be a very practical way in which, while we wait for specialist research to come through, we can still do something. I believe that the Bill goes a long way towards addressing the issues. The review of the orphan drugs regime, particularly the international angle, is hugely important. I welcome all the provisions in the Bill, especially those on the specialist registry and on the sharing of information to get more people into trials. As with any Bill, there are some things that I believe would benefit from further explanation, but that is what Committee is for. As shadow Secretary of State, I am happy to confirm that the hon. Member for Edinburgh South West has our support for the passage of his Bill through Second Reading and into Committee.

In this place and in life, there is a time to act. I believe that this is it. We have huge potential and huge talent in this country. Let us help focus that on saving more lives and giving more precious time to more people. I am pleased and proud to offer my support to the hon. Gentleman for the passage of his Bill.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 11th February 2025 Commons Chamber

[Mr Speaker]

Just a reminder that we are on topicals, folks.

[Edward Argar (Melton and Syston) (Con)]

I congratulate the hon. Member for West Lancashire (Ashley Dalton) on her promotion to the Front Bench.

Eating disorders affect over 1.25 million people, and this is the last Health and Social Care Question Time before Eating Disorders Awareness Week, which starts later this month. The Secretary of State will be aware of the amazing work done by the eating disorder charity Beat, which I met a few months ago, and to which I pay tribute. Will he back Beat’s call for broader access to intensive community and day treatment for those with eating disorders—there are limited places currently—and set out a timetable in which that will be delivered?

[Wes Streeting]

I really welcome the shadow Secretary of State’s raising that important issue. Too often, even when patients with eating disorders are in health settings, they do not receive the right care or support at the right time. I would be delighted to receive representations from Beat on how we can improve the situation.

[Edward Argar]

I am grateful to the Secretary of State for that answer. He will know that osteoporosis impacts 3 million people. He is aware of the campaign by the Royal Osteoporosis Society, and the powerful parallel campaign led by The Mail on Sunday and the Daily Mail, for access to fracture liaison services across the country. Pre-election, he committed to support that, and a roll-out plan. People will look for an answer that looks to the future, not the past, so when will he publish the fracture liaison services roll-out plan, to ensure that all who need to access those vital services can, and will he work with campaigners and me to achieve that roll-out before 2030?

[Wes Streeting]

This is unusually consensual today. The Government are committed to rolling out fracture liaison services across every part of the country by 2030. I promised that before the election, and that is what we are delivering. In fact, we have already started by investing in 14 hi-tech DXA—dual-energy x-ray absorptiometry—scanners, which are expected to provide an extra 29,000 scans to ensure that people with bone conditions get diagnosed earlier. I note that the shadow Secretary of State does not want to look to the past—I am not surprised, given the Conservatives’ record—but I am sure that we can work together in the future.

Rare Retinal Disease

Edward Argar Excerpts

Thursday 23rd January 2025 Westminster Hall

[Edward Argar (Melton and Syston) (Con)]

It is a pleasure to serve under your chairmanship, Dame Siobhain, and to do so debating a health matter, as we have spoken many times in the past about health issues. I am very grateful to the hon. Member for Strangford (Jim Shannon), who I call my friend, for bringing forward this debate.

I am equally grateful for the opportunity to serve opposite the Minister. She and I have served opposite one another on many occasions in the past—previously with me on the Government side and her on the Opposition side, but I am getting used to this side of the Chamber now. It is encouraging that she is responding because she engages with these debates and gives genuine answers. The debate will be the better for her being the Minister.

The hon. Member for Strangford has brought forward a hugely important debate, as he so often does. Many important issues rarely get brought before the House, yet we are the poorer for that. This debate might not otherwise have been tabled, but it is right that we debate the issue. I pay tribute to the hon. Member for Battersea (Marsha De Cordova), who is not in the Chamber but has done a lot in the House to highlight the issue in her work with the APPG—it would be wrong not to recognise that in this debate. I also pay tribute to the Royal National Institute of Blind People for its work and to all those who have contributed to raising awareness.

Before I became a Minister in 2018, I was the vice-chairman of the APPG on eye health and visual impairment, so I took an interest in this important issue back then, and it crossed my radar on a number of occasions when I was Health Minister. As the hon. Member for Strangford and the hon. Member for Leicester South (Shockat Adam) set out, while individual rare conditions may be exactly that—they occur rarely, with few people getting them—collectively, rare conditions account for a significant number of the conditions that individuals in this country have.

The hon. Member for Leicester South brought his background and knowledge to bear on the subject, as he does when speaking about these matters. He highlighted the potentially devastating impact that optical and retinal diseases and illnesses can have on someone’s life. A few years ago I did something very trivial; somehow—heaven knows why—a tree branch went right across my eye and cut it. I recovered fully, but for the few weeks that I had the treatment and the cream, it had an impact on my daily life. It was trivial in the great scheme of things—although if untreated, it may not have been—and I can only begin to imagine the impact of some of those conditions, as the hon. Member elucidated.

[Shockat Adam]

The right hon. Member should not feel bad, as that is the most common reason for eye trauma—gardening is the most dangerous sport for eye health. I have met people who lost their sight from a branch scratching their cornea.

[Edward Argar]

In which case, I remain very grateful to the clinicians at the Leicester royal infirmary. The hon. Member will be pleased to know that my wife shares his view about the dangers of gardening, particularly when I am doing it.

As right hon. and hon. Members can see, I am increasingly reliant on my reading glasses and my regular eye tests at Specsavers—other opticians are available. As the hon. Member for Strangford said, that is a reminder of the importance of the issue. A regular eye test not only can detect optical and retinal illnesses earlier, but can potentially spot other more serious conditions that are not directly related to eye health, but of very great significance.

[Jim Shannon]

I had two constituents in Newtownards who came to me complaining of a really sore head and a terrible colour. I said, “Have you been to the doctor?” “Yes,” they said. “Go and see your optician,” I said. On both occasions, they had tumours—one of them was the size of a golf ball; the other was growing. When they got to the A&E at Ulster hospital, they were retained and had emergency operations. With a simple interview and appointment, an optician can diagnose that early on, which can save someone’s eyesight and their life as well.

[Edward Argar]

The hon. Gentleman is absolutely right. He and I have known each other since we came to this House, and he has read my mind, because I was about to say that there are examples of life-threatening tumours being detected through a regular eye test and a referral onwards, which has saved people’s lives. As he set out, an estimated 25,000 or so people in the UK are affected by inherited retinal diseases. As the hon. Member for Leicester South said, the most common, which I will mispronounce, is retinitis—

[Shockat Adam]

Pigmentosa.

[Edward Argar]

I am grateful to the hon. Gentleman. As a professional optometrist, I am sure his bill will be in the post. Inherited retinal diseases can lead to a gradual loss of vision and can have potentially devastating effects.

[Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)]

My wife lives with retinitis pigmentosa. We have been together for 30 years, and over that time, I have seen how that degenerative eye disease can change the way that we live, adapt and care for each other as a family. Although there is a massive place, as we have talked about, for innovation and research and for access to investigation for treatment, once she got the white cane that she has now, that became a symbol for everybody else. People notice that she has a condition and they are much more attentive to her for that reason.

It is in the period before that where we could make an intervention around inclusion and education. Does the right hon. Gentleman agree that we could do something at that point to identify to others that somebody has a condition, which they might not be able to see, in order to help them?

--- Later in debate ---

[Edward Argar]

The hon. Gentleman is absolutely right. One of the key themes of this debate has been the importance of raising awareness and of societal understanding. Before I was a Minister, I co-chaired the APPG on dementia. I think we are making progress, but a large part of the challenge that we face as a society is raising the awareness and understanding of hidden conditions or things that might not be immediately apparent to people, particularly before there is a diagnosis or some sort of visual sign, such as a white cane, or other measures. This debate will play a small but important role in helping to raise awareness of those conditions.

The next challenge, as was alluded to, is diagnosis and what more can be done to deliver better and earlier diagnosis. Again, real progress is being made, but, as so often in these spaces, we can do more. It is a pleasure to be taking part in this debate, because although we often to and fro across the Dispatch Box or across the Chamber, I suspect that there is a fair degree of consensus today about where we are, what progress we have made and what more needs to be done, which is all to the good.

As has also already been alluded to, when there is a diagnosis, the next challenge is the treatment and what is possible in the way of treatment. In 2019, as has been said, NICE recommended the use of a new gene therapy called—again, I will use the abbreviation rather than the technical term—the Luxturna approach; I am sure that the hon. Member for Leicester South would be able to correct me, if necessary. It was recommended to treat inherited retinal dystrophies that are caused by a specific type of gene mutation. We are seeing real progress with that type of viral vector-based gene therapy. There are also potential new treatments that we have heard about, including further gene and stem cell therapies, artificial vision therapies, electrical stimulation therapies and indeed the use of growth factors and retinal transplants.

I have sat where the Minister is sitting now, so I know that there is always a challenge in this space. One of the great successes of our country is in innovation, including the rapid development of new therapies and new treatments. However, there must always be a process to make sure that they are safe and effective, and we must strike the appropriate balance in recognising that there is no infinite pot of money for any Government.

In August 2024, Retina Today, a respected journal, reported that there are currently over 30 gene therapies in development for the treatment of a range of retinal diseases, so we can look forward with a degree of cautious confidence to what is being done in that space. The challenge will always be, of course, how we translate such treatments into effective, deployable and—if I am being honest—affordable solutions for people who have such conditions. The situation is similar with artificial vision technologies, including the implanting of microchips. Therefore, there is reason for us be hopeful about treatment and research.

I now turn to the UK rare diseases framework, which hon. Members have spoken about today. It was first published in January 2021 and there have been a number of action plans since: there was one in February 2022, with 16 actions; one in February 2023; and one in May 2024. I was encouraged that in December 2024 the Minister’s colleague—the Under-Secretary of State for Health and Social Care, the hon. Member for Gorton and Denton (Andrew Gwynne)—reaffirmed the Government’s commitment to the rare diseases framework. I am also encouraged that there is talk of a 2025 refresh. I hope that the Minister can give a little more information on how she sees that process playing out when she speaks.

Some progress was made with those action plans, but if we are being completely honest, it was perhaps not as much progress as we might have wished. There are a range of external reasons for that, but there is now an opportunity for the new Government to continue to take the process forward. From what I see and hear, they are committed to and willing to do that, which is deeply encouraging.

With regard to NICE, I have already alluded to the challenges that it always faces. It has a difficult role to assess the clinical and cost-effectiveness of medicines and treatment, which is challenging because if someone is in need of a treatment—indeed, if they are desperate for a treatment—they will obviously want that treatment to be trialled. We therefore need to recognise that NICE does a difficult job in striking the right balance.

NICE uses the HST—highly specialised technology—programme. As we heard, refinements to the routing criteria have been proposed, including that

“The disease is ultra-rare and debilitating…having a point prevalence of 1:50,000 or less in England…is lifelong after diagnosis with current treatment, and…has an exceptional negative impact and burden on people with the disease”;

that there is the

“aim to encourage innovation and research”,

which is a good thing that we can all support; that

“The technology should be limited to the population in its licensed indication… No more than 300 people in England are eligible for the technology for its licensed indication, and the technology is not an individualised medicine”;

and that there are “no effective treatment options”.

I understand that just before Christmas NICE launched a public consultation, ahead of updating the HST eligibility criteria. That consultation is due to report later this year, following the closure of the consultation on 30 January. As I look at the date on my watch, I can see that hon. Members and other individuals have about a week or so in which to make any representations or put any views to that consultation, should they wish to do so.

I hope that the Minister will be able to update right hon. and hon. Members on each of those aspects—where she sees us going with diagnosis, treatment and access to treatment, and where she sees that research going in the long term. I hope the hon. Member for Torbay (Steve Darling) will forgive for not mentioning him before, but I pay tribute to him for bringing to his role and to this subject—as he does to his other speeches in this Chamber and the main Chamber, and to other debates since he has arrived in this House, not limited to this subject—a measured, thoughtful and knowledgeable approach. The House is all the better for those contributions.

Once again, I am deeply grateful to the hon. Member for Strangford for bringing forward this hugely important debate. This House is at its best when Members debate not the to-ings and fro-ings that we all put in our election leaflets, but consensual matters where there are genuine points of interest and where we can make a real difference for people. That is one reason why I was very keen, despite being the shadow Secretary of State, to speak in this debate—but also, of course, because it is a pleasure to serve opposite the Minister again for old time’s sake. I very much look forward to what she has to say and I am grateful to have had the opportunity to speak.

New Hospital Programme Review

Edward Argar Excerpts

Monday 20th January 2025 Commons Chamber

[Edward Argar (Melton and Syston) (Con)]

I am grateful, as always, to the Secretary of State for his typical courtesy in giving me advance sight of his statement. Labour was prepared to make all sorts of promises in opposition to win power—it promised not to raise taxes on working people, it said that it would not cut the winter fuel payment, and it promised to deliver the new hospital programme—but just as working people, pensioners, farmers and businesses have found, this is a Labour Government of broken promises. They have cynically betrayed the trust of the British people.

The Secretary of State and the Chancellor travelled the country to meet candidates who were promising a new hospital in their local area. In fact, despite my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins) calling them out in this very place in May last year, warning that Labour had said in the small print of its health missions that it was planning to pause all this capital investment, the Secretary of State was quoted in the Evening Standard in June last year to have said:

“We are committed to delivering the New Hospitals Programme”.

Those are seemingly hollow words now that those hospitals are at risk, with the investment and upgrades they deserve pushed back potentially to start in some cases as late as 2039. Voters put their trust in the Labour party to deliver on its promises, yet today they have been let down.

In response to claims that that is perhaps because of Labour’s economic inheritance, that simply does not reflect reality. Before the Secretary of State warms to the theme of the mythical £22 billion black hole, he will know that the Office for Budget Responsibility has simply failed to recognise that figure. Let us also be clear that, due to the Labour party and the Chancellor’s financial mismanagement at the Budget and the rise in gilts, the BBC recently estimated that the cost of borrowing could be £10 billion higher over this Parliament. Just imagine what the Secretary of State could have announced today if the Chancellor of the Exchequer had not caused that.

To govern is to choose: what to spend money on, what to invest in, and what not to invest in. The Secretary of State rightly pointed out that the Darzi review highlighted the need for more capital investment in the NHS, yet he has decided not to prioritise the delivery of these new hospitals in a rapid fashion. He will also know how the Treasury allocates funding, with cash earmarked to the end of a spending review period but not going across it until that comprehensive spending review formally concludes—that is what his Government are now doing.

The Secretary of State will be aware that the previous Secretary of State, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), was very clear about the £20 billion anticipated in the next CSR to fund this. Let me be clear: we prioritised the delivery of these new hospitals, as my right hon. Friend did in his statement on RAAC on 25 May 2023, setting out the Government’s commitment to fund them. This Secretary of State has not replicated that.

We had a clear plan, with that funding commitment to be formalised at the CSR, to approve, build and complete new hospitals to a definition akin to that used by Tony Blair when building new hospitals, which were already being designed to a standardised approach with modern methods of construction. The Secretary of State has put that progress at risk. Will he confirm that in his CSR discussions with the Chancellor of the of the Exchequer about the capital departmental expenditure limit—CDEL—allocation for his Department, he will prioritise the new hospital programme? When will the Secretary of State set out to local people in each area exactly when construction will start? I declare an interest: University Hospitals of Leicester NHS trust serves my constituents. In each case, when will the doors actually open?

If the Chancellor fails to get the economy growing and starts looking yet again for cuts to fill the hole that she created with her Budget, will the Secretary of State rule out any further delays? What is his assessment of the effect of his lengthening the programme’s timescales on costs, given inflationary pressures? Are all other previously approved capital projects and programmes safe from review? Can he possibly update the House—via the Library if not here—on his latest assessment of the impact of RAAC in those hospitals, which rightly he is continuing to prioritise?

Today’s announcement will come as a bitter blow to trusts, staff and, crucially, patients, who believed the Labour party and will now be left waiting even longer for vital investment. Yet again, before the election, they talked the talk, but patients lose out when this Government fail to deliver. In yet again kicking the can down the road, as is increasingly their habit, they have sadly betrayed the trust of the British people.

[Wes Streeting]

This weekend the Leader of the Opposition said that she will be honest about the mistakes of the Conservative Government. It seems that the shadow Health Secretary did not get the memo. If the Leader of the Opposition is serious about showing some contrition, she might want to start here. In 2020 the Department of Health and Social Care requested funds from the Treasury to rebuild the seven RAAC hospitals. That request was denied, setting back the necessary rebuild of those hospitals by years. The shadow Secretary of State will remember this, as he was a Minister in the Department at the time. Which of his colleagues was a Treasury Minister when it blocked the rebuild of the RAAC hospitals? The Leader of the Opposition. That is her record. She should apologise.

Once again, like the arsonist returning to the scene of the crime to criticise the fire brigade for not responding fast enough, the Conservatives have the audacity to come here and talk about a failure to deliver, when promise after promise was broken. The shadow Secretary of State was the Chief Secretary to the Treasury who had to come in to clean up the mess caused by Liz Truss’s mini-Budget. That is what crashing the economy looks like. They still have not had the decency, even under new leadership, to apologise.

If the shadow Health Secretary genuinely believes that all these projects could be delivered by 2030—the commitment in the Conservatives’ manifesto—I invite him to publish today their plan for doing it. How would he ensure the funding, labour supply, building materials and planning to build the remaining projects in the next five years? Which capital programmes would he cut? Which taxes would he increase? He knows as well as anyone that those are the choices that face Government.

While he is doing that, can the shadow Health Secretary tell us what he can see that the National Audit Office, the Infrastructure and Projects Authority and the eyes in my head cannot see? What was the Conservatives’ plan past March, when the money runs out? What taxes would they have raised? I wonder what capital projects they would have cut in order to invest even more than we are in hospital buildings—the biggest capital investment since Labour was last in office.

While he is answering those questions, the shadow Healthy Secretary might want to reflect, with the shadow Cabinet and with Members on the Benches behind him, on the other messes that this Government are having to clear up. As I look around the Cabinet table, I see an Education Secretary dealing with crumbling schools, a Justice Secretary without enough prison places, a Defence Secretary dealing with a more dangerous world, a Transport Secretary having to rebuild our crumbling infrastructure, and a Deputy Prime Minister building the homes we need—in short, dealing with multiple crises of the Conservatives’ making. There is a massive rebuilding job to do in Britain, and we are getting on with it.

--- Later in debate ---

[Lincoln Jopp (Spelthorne) (Con)]

I will say it, because no one else has: many happy returns for tomorrow. I genuinely thought that you were in your mid-30s—that the Secretary of State was in his mid-30s.

[Edward Argar]

And Madam Deputy Speaker. [Laughter.]

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

She’s happy with that!

Health and Social Care: Winter Update

Edward Argar Excerpts

Wednesday 15th January 2025 Commons Chamber

[Edward Argar (Melton and Syston) (Con)]

As ever, I am grateful to the Secretary of State for his typical courtesy in giving me advance sight of his statement. May I join him in saying that our thoughts are with the nurse in Oldham who was so viciously attacked? Like him, we wish her a full and speedy recovery. May I also echo his words of gratitude to NHS and social care staff for all they do to help and support patients and our constituents?

We last heard from Ministers on winter pressures just before Christmas. Yet, as the Secretary of State has set out, the situation has continued to grow more severe. We have all heard about those pressures in the media and from patients, constituents and staff. Indeed, I will take this opportunity to acknowledge the work of the hon. Member for Tooting (Dr Allin-Khan), who I know has been on the frontline and has, I suspect, seen those pressures—the unacceptably long waits in A&Es for ambulances, and corridor care and its impact on patients—at first hand. When someone calls an ambulance, they need to know that it will come, but it cannot if it is sitting in a hospital car park. At my local hospital in Leicester, for example, over 36% of ambulances handing over had a one hour-plus wait, and I am sure that that is replicated around the country.

The Secretary of State highlights that the number of patients in hospital with flu is triple what it was a year ago, yet it appears that the rate of flu vaccine uptake for over-65s, at-risk groups and healthcare workers is lower than last year. He wants more people to be vaccinated, and I share that view, but will he set out in more detail what he is doing to further drive vaccine rates and ensure that vaccines are available for all those who need and want them?

As the Secretary of State said, more than two dozen hospitals declared critical incidents last week. Although I welcome the fact that the vast bulk of those incidents have been stood down, will he set out what support and additional resource is being offered not only to hospitals that have reached the point of declaring critical incidents, but to others that continue to face pressures?

Last year, the Government provided additional funding for hospitals and social care to boost capacity and, vitally, the number of beds in hospitals, as well as to tackle delayed discharges. Will the Secretary of State set out in more detail what he is doing in a similar vein? Will he update the House on how many people currently in acute settings are fit for discharge but have not been discharged for a variety of reasons?

The Secretary of State mentioned pay, and said that he had negotiated a deal. I say gently to him that what he did was not negotiation but capitulation to an inflation-busting pay rise.

None of these pressures comes as a surprise to me or to the Secretary of State. He was open and candid, as he often is, in acknowledging that there would be a winter crisis this year. NHS England directors were warning that they did not have the resources needed to surge capacity or increase social care packages now, which the Conservative Government provided in previous years. The royal colleges said that nothing had been done to mitigate a winter crisis, and NHS organisations said that they needed more support to prevent ambulance delays, overcrowded A&Es and people being stuck in hospital beds because of a lack of community and social care. He knows—we have spoken about it before—the importance of flow from ambulance to A&E, and from A&E to a bed or to discharge. What extra steps is he taking to increase the number of care packages now rather than in the future, and will he consider allowing community hospitals, such as mine in Melton Mowbray, to play a greater role in providing care to local communities in order to ease pressure on acute settings?

Those concerns were all raised in September and October. My predecessor as shadow Secretary of State, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins), asked about them, yet the Secretary of State failed to provide an update to the House until Ministers came to the House just before Christmas. Indeed, I recently asked a named day question about when the Secretary of State started chairing his weekly winter preparedness meetings. Despite, one hopes, a quick look at his diary giving the answer, I received a holding answer. I only got the correct answer after that holding answer had been sent to me, stating that it was in December. Can he say on which date in December the first of those meetings was held?

Before Christmas, I and the Conservatives called for a winter-specific bed increase plan. We still have not had one. Will the Secretary of State set out what he is doing to increase the number of beds and the amount of capacity now?

While the Secretary of State talks the talk, he has not done the work ahead of this winter. Will he now reassure patients and staff that he will urgently boost capacity, resources and support to ensure our constituents get the care they need when they need it?

[Wes Streeting]

Where to begin, Madam Deputy Speaker? The shadow Health Secretary does a really good line in diagnosing the problem as if these are somehow new facts to him, or to the country. In fact, one does not have to be a Minister of long service in this House, or indeed a Member of long service, to remember that only a short matter of months ago, the shadow Secretary of State was a Minister in the Department. Time and again, he asks questions about the state of the crisis and the challenge in the NHS without showing a shred of responsibility for that crisis, which he played a part in creating.

It is not just the shadow Secretary of State but every one of his predecessors who had a hand in creating the situation that Lord Darzi spelled out: underinvestment and botched reform. It is the situation we see today, with pretty much every part of our health and care services—be it primary care, community care, mental health services, secondary care or social care—under extraordinary and historic pressures. It is all very well criticising from the Opposition Benches, but the shadow Secretary of State demonstrates the same pattern of behaviour as his predecessor: acting like the arsonist criticising the fire brigade for not doing enough, quickly enough, to put out the fire they started. It is truly shameful.

I turn to the questions raised by the shadow Secretary of State. On delayed discharges, in December—the latest data we have—12,000 on average per day were medically fit for discharge but unable to be discharged. Bed numbers are broadly the same as they were this time last year: 102,546, versus 102,226 under the previous Government. That actually says something about what we have experienced in our weekly updates: the work that is taking place between health and social care services to improve the flow of patients is having some effect when we take into account our ability to flex bed numbers up and down against the backdrop of higher occupancy from flu, the added challenge of norovirus, and the other seasonal conditions that we see at this time of year.

The shadow Secretary of State asked about vaccination uptake. As I said in my statement, there have been more flu vaccinations this year than there were last year, but he raised the important issue of vaccination rates among NHS staff. Those rates are lower than we would like or expect, and we have to do some work with staff to understand why that is the case and how we can encourage further uptake. As I said, if staff are suffering with flu having not been vaccinated, not only is that a really unpleasant experience for them, it is an unpleasant experience for their colleagues if staff are off sick, and indeed for patients who are waiting longer.

On critical incidents, the shadow Secretary of State asked about the support that is being provided to NHS organisations. NHS England regional teams are working closely with integrated care boards to ensure appropriate responses are in place to address and mitigate the issues identified within each declared critical incident, all of which will have variations. We have also seen NHS England—rightly, in my view—using the critical incident tool proactively to ensure we can provide wider system support to emergency departments that are under particular pressure.

The shadow Secretary of State asked about additional funding for winter. When I was shadow Health and Social Care Secretary, I was very clear about my cynicism regarding the pattern of behaviour we saw from our predecessors. Year after year, they would arrive in the middle of winter—often after the winter peak—with a gimmicky package of last-minute funding that delivered too little, too late without making any real difference on the frontline, all to give the impression that they were doing something to mitigate the crisis in the NHS, in which they played a serious part. I said that we would not do that, and we are not doing it. As soon as we came into office, looked at the books and saw the black hole, the Chancellor released additional funding for the NHS in-year to ensure that it had the resources it needed not to cut back. Thanks to the decisions taken by the Chancellor, the NHS has received more than £2 billion more in-year than it would have received if the Conservatives had remained in power, so we do not need any lectures on funding. Indeed, they continue to oppose the £26 billion we provided for the NHS.

Finally, the shadow Secretary of State accuses us of capitulation to frontline doctors who were out on strike because of the way they were treated by our Conservative predecessors. I just say to resident doctors who are following these proceedings, and to patients who can see the state of the NHS today and wish it were better, that we are now left in no doubt. Had the country kept the Conservatives in power, doctors would have been on the picket lines instead of the frontlines this winter; taxpayers would have continued to pay a heavy price for failure; and patients would continue to pay the price through delayed, rearranged or cancelled operations, appointments and procedures. It is proof positive that even after it was booted out of office, the Conservative party has not listened, has not learned, and is not fit to govern.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 7th January 2025 Commons Chamber

[Mr Speaker]

Order. May I remind Members not to walk past when the Minister is replying to a question? Please have regard for each other; this sets a bad example.

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

The Prime Minister’s announcement yesterday of his elective recovery plan mirrored that of Sir Saijd Javid in 2022, but one aspect was different. Our plan explicitly recognised the importance of the workforce being in place to deliver the 9 million extra tests and interpret the results, and it set out proposals to increase that workforce further. What plans has the Secretary of State to boost the workforce in community diagnostic centres specifically, over and above the plans that he inherited from us, to ensure that his elective recovery plan is deliverable?

[Wes Streeting]

The shadow Secretary of State is right to say that we need staff in place to do the job. The additional funding announced by the Chancellor in the Budget is central to the delivery of this plan—I note that he opposes that funding, which is deeply regrettable—but we need to improve productivity as well. That is why the plan sets out steps to free up patient appointments that are unnecessary or of low clinical value, but, crucially, staff time in productivity gains is also important, so as well as making the most of the additional investment, we are making the most of delivering value for taxpayers’ money—

[Edward Argar]

On hospices, while the Secretary of State’s pre-Christmas hospice funding announcement was, of course, welcome, the vast bulk of it was in fact non-recurring capital funding, which cannot be used to help them cover the hiked employer national insurance tax on hospices’ most precious asset: their staff. What steps is he taking to ensure that they receive recurring revenue funding, to enable them to cover the additional costs?

[Wes Streeting]

The £100 million capital investment we set out before Christmas is the biggest boost to hospice funding in a generation, and it comes on top of the £26 million that we announced for the children and young people’s hospice grant. The right hon. Gentleman cannot welcome the investment and keep opposing the means of raising it. Would he cut services or raise other taxes? He has got to answer.