Covid: Fifth Anniversary

Edward Argar Excerpts

Thursday 12th June 2025 Commons Chamber

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

I congratulate the hon. Member for West Ham and Beckton (James Asser) on his speech and on securing this important debate. The vast majority of contributions today have been measured, thoughtful and non-political, and I think they have done this House proud. It is right that we remember, reflect and learn. It is the least we owe those who lost loved ones during the pandemic.

As someone who during the pandemic was doing the job of the Minister, I recall it incredibly well, as will so many in this House and outside it. The hon. Gentleman said—I know what he meant—that with the passage of five years, sometimes what happened then can feel a bit like a dream. It is something that still catches me in mine at night. I often wake with a jolt, suddenly remembering vividly something that took place then—something that we did or had to do, or a particular moment as a Minister. I suspect that that is true of many up and down this country in many different walks of life, particularly those who were on the frontline.

[James Naish (Rushcliffe) (Lab)]

My wife was an obs and gynae doctor, and she still is. She was one of those people on the frontline whom the shadow Secretary of State describes. Does he agree that there needs to be a study into the long-term impact on the wellbeing of staff who were on the frontline dealing with these traumatic situations, so as to understand the impacts on health and productivity within the NHS?

[Edward Argar]

That is important, because people up and down this country still live with the impacts of the pandemic through long covid and mental health challenges. We see that huge impact still today on individuals and the NHS. We must remember how the country came together in the face of unprecedented events, about which we learned more every day. We had to adapt our approach to that changing knowledge. I am grateful to all Members from all parts of this Chamber for what they did.

A few Members in the Chamber were in the House at the time, and they will remember the work of Jon Ashworth, which I recognise in particular. He was in this place at that time, and I remember his cross-party approach to so much that was done. I pay tribute to the emergency services, to councillors and to the people of this country, particularly those who worked in health and social care and those who lost someone.

It was a traumatic time for the whole country. There are lessons that must be learned about planning for future pandemics and supporting those with long covid. The hon. Member for Honiton and Sidmouth (Richard Foord) was right—like so many, I have constituents who lost loved ones and family members who were affected by the vaccine, as has been recognised by a coroner. They have been dignified and courteous, but they call for the Government to review the vaccine damage payment scheme. I hope that the Minister will take that suggestion in the spirit in which it is intended.

We owe it to this country to make sure that we are better prepared for any future pandemic. We owe it to those who lost loved ones and those who suffered in so many different ways: those with long covid, those with mental ill health, kids who were unable to attend school, domestic abuse sufferers and those who still suffer today. It is right that we remember, reflect and debate, as we do now, in order to learn.

As a former Health Minister, I have memories that continue to surface. We will all of us live with our memories of that time till the end of our days. The least we can do is to ensure that this House and this country always remember and reflect carefully on what we can do better next time.

Spending Review: Health and Social Care

Edward Argar Excerpts

Thursday 12th June 2025 Commons Chamber

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

Yesterday, yet again, we saw the Chancellor do what the Labour party always does: default to high spending, more borrowing and higher taxes, leaving the public finances vulnerable. The Minister has spoken of additional funding for the NHS. To use the same comparison as the NHS England chief executive, the NHS budget will now be roughly the equivalent of the entire GDP of Portugal, yet we are still none the wiser as to how the Government actually intend to use most of the money—there is no real detail and no real plan. Just last September, the Prime Minister pledged that there would be no more money without reform. Despite the Minister’s words, that is exactly what the Government have done. There is still no plan for reform, and the Secretary of State is unwilling to set out the bold reforms that are needed.

Despite 14 years in opposition and nearly one year in government, the Labour party has failed to come up with a plan for the NHS, with the exception of the abolition of NHS England, which will not happen for years and appears to be delayed and in chaos. Ministers respond to every written parliamentary question about it by saying they cannot set out the savings, how the people will change or how the structure will change at this stage—yet again, there is still no plan. We have been very clear that where the Government are wrong, we will oppose it, but where they get something right, we will work constructively with them. That includes reform, but there is still no reform for us even to consider supporting.

Can the Minister tell us where the £29 billion she set out will be spent? The chief executive of the NHS Confederation said yesterday that increases in NHS staff pay will

“account for a large proportion”

of the funding increase. The former NHS chief financial officer echoed that view at the Health and Social Care Committee in January, saying that pretty much all the last tranche of additional spending was absorbed by pay rises, national insurance and inflation. Can the Minister confirm how much the pay offers from the independent pay review bodies, alongside increased national insurance, will cost, how much of this funding will have to go to cover that and how much will actually make it to the frontline to improve patient services?

The Minister touched on the aim of meeting the NHS 18-week target for hospital waiting times within this Parliament. Of course, we wish the Government well in achieving that and hope they succeed, but just yesterday The Times reported that internal departmental modelling showed they are not on track and could only come close to meeting the target with “implausible” and “over-optimistic” assumptions. The independent Institute for Fiscal Studies agreed. Can the Minister set out how the Government will meet that target? Again, where is the plan? We need a plan, not empty rhetoric.

It is clear that the NHS needs reforms, not just more funding, so when will the 10-year plan finally be published? Will it be before the one-year anniversary of the Labour party being in government? Will it be like their elective reform plan: simply a reheat of the plan that Sajid Javid brought forward in 2022, with nothing new? The Secretary of State needs to be more ambitious—words that I suspect will never be echoed by the Prime Minister or his team in No. 10.

The capital budget remains broadly flat in real terms from this year onwards. The Minister has said she wishes to continue with the new hospitals programme and invest in technology to boost productivity, but it is unclear how that can be achieved with this settlement. These are not my warnings but those of respected independent think-tanks, including the Nuffield Trust and the King’s Fund. The Chancellor’s plan is clear—indeed, not one Treasury Minister has ruled it out: more tax rises are coming.

Finally, and importantly, we have seen social care largely neglected again by this Government. There were just two sentences about it in a four-page statement. Social care deserves better. The Minister knows very well that we cannot improve the NHS without social care working well. Earlier today I met with social care providers. They want to see reform, yet the Government have apparently abandoned cross-party talks on social care reform for an independent commission led by the very able Baroness Casey, who is still doing her Home Office work on grooming gangs and is yet to be full time on this commission, which has a deeply unambitious finishing time of 2028. When will Baroness Casey be full time on the commission? These providers were clear that they want a seat at the table when better care funds are distributed by the NHS—they want to have their voices heard in decision making on that funding. Will the Minister agree to that?

Finally, the Chief Secretary to the Treasury said he has modelled his assumptions on continued trends in local government finance and local government precepts —in other words, a 5% uplift in the precept. However, a large number of counties are now controlled by Reform—whose Members are, as ever, notably absent from the Chamber when we talk about health and social care—who have pledged no tax rises whatsoever in their councils. If they do that, what is the Minister’s plan to make sure social care is funded? As ever, the Government have gone for the headline announcement, but sadly without a plan, without delivery and with no real reform to benefit patients.

[Karin Smyth]

I am entirely unclear, after that run-through of a number of different issues, whether the Conservatives welcome the extra investment in the NHS or oppose it. We know they oppose the means of funding it, but after that, I have no idea. At some point, they have to make up their mind whether they support that extra investment or not. As I said in my statement, if they do not, what out of the list of the improvements that we have already made would they not do?

As Lord Darzi made clear, under the Conservatives’ watch for 14 years the NHS was broken. Staff were left with out-of-date equipment and unable to do the job they needed to do. We agreed with Lord Darzi’s diagnosis, but Conservative Members have still not said whether they agree with it, or apologised for the state they left the system in. I do not know whether the right hon. Member for Melton and Syston (Edward Argar) has not been able to read the elective reform plan or the urgent emergency care plan that we published recently. It is up to him to read those plans properly and try to understand what is happening.

The right hon. Gentleman has started to do my job for me again, because he cites various think-tanks and people who have said that this cannot be done. Well, I can tell him that we were told, for example, that waiting lists would not drop in April because of seasonality, but we have shown—by keeping a relentless focus on the system, working closely with leaders on the frontline and being clear with officials in the Department—that it can be done. That is what we heard this morning.

We are taking a relentless approach to spending, line by line, throughout the NHS and the Department of Health and Social Care. We have rolled up our sleeves and we will not accept putting more and more taxpayers’ money into a leaky system, which is what happened under the right hon. Gentleman’s Government. If he had read the patient satisfaction survey, he would know that taxpayers across the country, in all our constituencies, love the NHS. They understand that the Tory party broke it and that it will take long time to fix. They also know that they are paying more taxes for it and getting a worse service, and they expect us to do much better. That is what we have already shown we are doing, and what we will continue to do.

I have outlined the capital that is going into the new hospital programme, which we are committed to, and we have already seen increases in diagnostic capability and surgical hubs throughout our constituencies. We will continue to do more of that. I agree with the right hon. Gentleman that it is critical to ensure that social care is supported alongside the NHS. That is why £4 billion is going into social care through our colleagues in the Ministry of Housing, Communities and Local Government, and as he knows, Louise Casey will publish her interim report next year.

We are clear that fiscal responsibility does not stop at the Treasury or down in Victoria Street with the Department of Health and Social Care. It is important that everybody in the NHS is aware that we are determined to fix the NHS and put it back on a sustained footing. There is record investment; that is our commitment to people, and I know from the people I worked with in the health service over many years that they are determined to make it better. Morale sank to an all-time low under the Conservative party, but we are raising that morale, and we will continue to work with the system to make sure that it is fit for the future.

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!