Teignmouth Hospital

Edward Argar Excerpts

Tuesday 9th March 2021 Westminster Hall

[The Minister for Health (Edward Argar)]

It is a pleasure to serve under your chairmanship, Sir Charles, in a sense for the second time. In my first Committee post in the House, when I was first elected, I served under your chairmanship on the Procedure Committee.

I congratulate my hon. Friend the Member for Newton Abbot (Anne Marie Morris) on securing this debate on such an important subject, and one that I know she has taken a close and long-standing interest in on behalf of her constituents, for whom she is a very strong local voice. From the outset, I pay tribute—I suspect with her—to the amazing work during the pandemic that has been done by not only all those working in our NHS but those in her local trust and hospital. I hope I might prevail on her to pass on my thanks to her local team.

As my hon. Friend set out, Teignmouth Community Hospital is part of Torbay and South Devon NHS Foundation Trust and provides health and care services to patients across Teignmouth and Dawlish. She set out their work very clearly in her speech, alongside a very helpful exposition of the broader health and social care context in the area in which she serves as the Member of Parliament. She recognised it, quite rightly—I hear her plea—as a whole system, and the broader picture, rather than as individual siloed parts of a health system. In the past, she and I have had the pleasure of discussing what she cares deeply about, which is the future evolution of health and social care as a coherent single model. I hope that it will not be too long before we can have those conversations in person again in this place.

As part of its work on ensuring that services across Devon are, as the CCG sees it, fit for the future and fully address the aspirations of the NHS long-term plan, the CCG, as my hon. Friend says, has been reviewing how services are provided and how to best integrate services in order to make improvements for the most vulnerable people in the communities that it serves. Considerable progress has been made in this area, for which I highlight the work of the CCG.

However, the ongoing review process has highlighted that three main cases for change remain, in the view of the CCG: that the joined-up community care now provided means that, in the CCG’s view, the 12 rehabilitation beds previously promised for Teignmouth community hospital are no longer needed, and my hon. Friend made very clear her views on that on behalf of her constituents; that there is a pressing need to safeguard the future of primary care across the entirety of the area she represents; and that both the national local strategies to integrate care further make the best use of the NHS estate.

The CCG’s reviews of the need for rehabilitation beds at Teignmouth hospital led it to believe that the health and wellbeing team was successfully meeting the needs of local patients without them, but my hon. Friend set out clearly her concerns about that conclusion and the reasons why she has those concerns. I will mention at this point an important contextual point. While hopefully many things we have seen in the past year relating to covid will become things of the past soon, it is highly likely that covid has changed the nature of how we look at the provision of healthcare, and that there are lessons to learn there for the long term and for the future. I think I heard her clearly saying that we should not lose that by virtue of something that was begun before covid not being able to scoop up and learn those lessons for the future—i.e. future-proofing the services that her constituents rely on. I am sure that the CCG will have heard her message loud and clear on that particular point.

My hon. Friend talked about the consultation and the decision-making process in some detail. Clearly, as I gather from that and from a letter she has recently written to the Secretary of State, which I will turn to in a moment when I conclude, she has undertaken a lot of work in looking at these consultation processes, the history of them, the genesis of them and how over time they have changed what they have been looking at.

As my hon. Friend said, the CCG undertook a formal consultation from 1 September to 26 October 2020—I caveat that with the point that my hon. Friend and I made earlier, which is that that was mid covid and not after the covid pandemic—which proposed to move high-use community clinics from Teignmouth community hospital to a health and wellbeing centre in Teignmouth; to move specialist outpatient clinics from Teignmouth community hospital to Dawlish community hospital, four miles away; to move day-case procedures from Teignmouth community hospital to Dawlish community hospital, which she picked up on clearly in her speech at the opening of the debate; to continue with that model of community-based intermediate care; and to reverse the decision to establish 12 rehabilitation beds at Teignmouth community hospital, as advocated by the CCG and, it asserts, as supported by previous public engagement in 2018 on the success of the service provision without the beds.

I understand that NHS England’s position is that the consultation in 2020 set out that a likely consequence of the reconfiguration was that the requirement for those beds in Teignmouth would no longer be there for the local NHS. However, I hear what my hon. Friend says; she highlighted that, in her view and that of her constituents, that is worthy of a more discrete and focused consultation.

The consultation was overseen by the independent Healthwatch for Devon, Plymouth and Torbay, which analysed the just over 1,000 responses received, finding that 61.3% of respondents were in favour of the overall proposals. The equality impact assessment undertaken indicated that, overall, the impact on people using the services affected by this proposal was deemed by them to be of benefit, while the EIA indicated that, overall, the impact on people using the services affected by this proposal was neutral or of benefit.

Following a review of both consultation feedback and the quality and equality impact assessments, the steering group approved the consultation and agreed to make a recommendation to the CCG governing body that all four elements of the consultation proposal be approved. The Teignmouth steering group approved the consultation and the local NHS plans to continue to review the proposed model of care in light of potential changes in levels of need within the local area, as well as—they have related to my office—the impact of covid-19 on ways of working. I will turn to that in a minute, as well as an offer that I will make to my hon. Friend when I conclude.

I am aware that, as she has said, local councillors recently wrote to the independent reconfiguration panel to seek informal advice on this reconfiguration, and have been advised to continue to work co-operatively with the CCG to find a local resolution. My understanding is that the IRP is constrained in what it can or cannot do and how it can engage where it is not a formal referral, but I understand from what my hon. Friend said that that remains a possibility, so I will be a little cautious about prejudging whether that may or may not happen. She asked a number of specific questions—for example, about Chorley, and then her asks at the end of her speech. What I would say about Chorley is that we do not have the power to instruct in the context of reconfiguration at this point, hence the legislative proposals that she talked about. We requested that they look at this, which they accepted, but I add the slight caveat that, as I understand it, we do not have the legal power to instruct the local CCG to do x or y at this point in the reconfiguration.

However, what I can offer to her within that legal constraint, which may be of help to her, is that first, of course, I will endeavour to reply to her letter swiftly, with responses to the detailed points she has raised in it. Secondly, although the legal powers available to me in the name of the Secretary of State are limited until and unless an IRP referral is received and the advice is then given, I am always delighted to meet with my hon. Friend if she feels that would be helpful. It may be helpful to her if I arrange to meet with her outwith this debate, to discuss with her in more detail some of the process points and legal constraints, but also to listen in more detail than she is perhaps able to set out in a debate of this sort. I would expect her CCG to have heard her voice in the House today loud and clear, as I suspect it does in her capacity as the local Member of Parliament on the ground in Newton Abbot.

It is right that all reconfiguration decisions are taken in the best interests of patients and the local population following the due process, and it is that due process that slightly constrains what I can say or do in this context. However, the Government are committed to ensuring that the appropriate resources are available to the NHS in Devon to support patients, and to continue to provide the people of Devon and of her constituency with the best possible care, so the people affected by these changes need to be involved in making the key decisions—including my hon. Friend, of course, as their elected voice. I would hope and expect that the CCG will set out a clear plan to engage proactively with her and with the local population, and would encourage all of her constituents to be involved in that process.

I will reiterate two things on the record. First, I will of course reply to my hon. Friend’s letter. Secondly, I repeat my offer to meet with her separately to discuss in more detail what is and is not possible within the legal constraints around the reconfiguration process, and also to learn more about Teignmouth Hospital. I hope that in more normal times, when such things are possible, I might be able to come down and see my hon. Friend in sunny Devon, to visit that hospital with her.

Question put and agreed to.

Covid Contracts: Judicial Review

Edward Argar Excerpts

Wednesday 24th February 2021 Commons Chamber

[Rachel Reeves (Leeds West) (Lab)]

(Urgent Question): To ask the Minister for the Cabinet Office if he will make a statement on the recent judicial review ruling, which found the Government had acted unlawfully in respect of covid contracts.

[The Minister for Health (Edward Argar)]

Protecting those who protect us has been one of the Government’s most important goals in our fight against covid-19. To do that, we have had to expand our personal protective equipment supply chain—it has gone from supplying 226 NHS trusts in England to supplying more than 58,000 different settings—and we have had to create a whole new logistics network from scratch. Thanks to the hard work and dedication of so many people, we have delivered more than 8.6 billion items of PPE to the frontline so far, with billions more ordered and being supplied.

Our team worked night and day to procure PPE within very short timescales and against the background of unparalleled global demand. That often meant working at incredible speed, especially in the early months of the pandemic, to secure the vital supplies required to protect NHS workers and the public, which we did.

Let me turn specifically to the High Court judgment. There has been a lot of confusion about what the ruling said and did not say, and I welcome the opportunity to clarify that to the House today. The High Court case did not look at the awarding of the contracts; rather, it looked at the timing of the publication of the details of contracts awarded. The court ruled that at this time of unprecedented pressure, contract award notices were not all published in the timescales required by the regulations. However, it also found that there was no deprioritisation policy in that respect in the Department. As we set out to the court, the delays were caused by the workload involved in responding to one of the greatest threats to public health that this country has ever seen.

We take our transparency requirements very seriously, and it is important that I put on the record that we of course take the judgment of the court very seriously and respect it. We are working with colleagues across Government to implement the recommendations set out in the report published earlier this month by the Public Accounts Committee, chaired by the hon. Member for Hackney South and Shoreditch (Meg Hillier), but as we do that, we will keep acting quickly and decisively to respond to this deadly threat, and we continue to do all we can to help save lives.

[Rachel Reeves]

A stain has emerged on this Government’s response to the crisis. There has been an unedifying goldrush of chums and chancers; £2 billion-worth of contracts have been handed to those with close links to the Conservative party, from the Health Secretary’s pub landlord, to the donors, manifesto writers and the old boys’ club—they have all had a return on their investment at our expense.

The Government have been taken to court, and they lost, which cost taxpayers even more money. The Home Secretary once said that she wanted people

“to literally feel the terror at the thought of committing offences.”

She does not have to look to the streets to find law-breakers; she only has to look across the Cabinet table. This Government are not terrified of breaking the law, because they think they are above the law.

Now that the Government have lost in court, I ask the Minister: what was the cost to taxpayers of fighting this case? Will the Government agree today to publish the names of all businesses in their VIP fast lane and say how they got on that list? Will all overdue contracts be published by the end of this week? When will the management consultants hired locate the billions of pounds of PPE that the Government seem to have misplaced? When will clawback be used to get back taxpayers’ money for contracts that have failed to deliver? Will the Minister take this opportunity to apologise to the doctors, nurses, care workers and other frontline workers who did not have the PPE that they needed, and who had to make makeshift PPE—because, contrary to what the Health Secretary said, there was a shortage of PPE and those working on the frontline were not protected?

While he is here, will the Minister, Serco’s former head of public affairs, reveal the mystery of why the Government created Serco Test and Trace, rather than a true NHS test and trace embedded in our communities? NHS workers, care workers and taxpayers deserve better. We deserve the end of crony contracts from this Government.

[Edward Argar]

Notwithstanding the circumstances and the approach adopted by the hon. Lady, it is a pleasure to appear opposite her at the Dispatch Box for the first time. She raised a number of specific points, but before I turn to them, I have to reiterate what the judgment did and did not do. The judgment focused on timely publication of contract notices; it did not make any judgment on, or consider in any way, the appropriateness of the contracting process or any of the individual processes.

The hon. Lady alleges impropriety and inappropriate behaviour—wrong. The National Audit Office report was absolutely clear that there was no evidence of any inappropriate behaviour, and indeed no court has found this. I highlight to her that the judgment was a declaratory judgment, and it stated that there had been a breach of the regulation 50 requirements. The judge subsequently highlighted, in paragraph 149:

“But the overall picture shows the Secretary of State moving close to complete compliance. The evidence as a whole suggests that the backlog arose largely in the first few months of the pandemic and that officials began to bear down on it during the autumn of 2020.”

I remind the House, and indeed the hon. Lady, of the situation we faced back in April. There were 3,301 people in mechanical ventilation beds, 21,307 people in hospital with covid, and at the beginning of April, according to our best understanding of positive cases at the time, the average number of positive cases and patients in hospital was doubling every seven days. In those circumstances, I make no apologies for the Government doing everything in our power to ensure that the NHS and frontline workers did not run out of PPE. As the National Audit Office has acknowledged, there was no national shortage of PPE at the time and throughout the pandemic.

The hon. Lady asked a number of questions. She talked about the current situation regarding publication, compliance and costs. As I have mentioned to her briefly before, there is an element of this case that is yet to be concluded, as some information is due to be provided to the judge on Friday. We will do exactly that, and the information will be made public when it goes to the court. We respect the court’s role in the process, but I expect the judge to have that published in a couple of days’ time.

On the priority route, if I recall correctly, many Members on both sides of the House requested expeditious consideration of offers of help, and I am grateful to all who made those offers. Every one of those went through an eight-stage process, run by civil servants, entirely appropriately. They checked the appropriateness of the PPE and the organisation supplying it, and conducted due diligence. Indeed, as I recall, the hon. Lady herself, on 22 April, published a letter that she had sent to the Chancellor of the Duchy of Lancaster—it was helpfully analysed at the time by the Guido Fawkes website—sharing some of her suggestions of companies or individuals that should be put through rapid assessment. I acknowledge that she said that there should be assessment and due diligence, but she asked that they be assessed rapidly. I believe that many Members of the House took the same approach. In that letter, she concluded:

“We need Government to strain every sinew and utilise untapped resources in UK manufacturing, to deliver essential equipment to frontline workers. This must be a national effort which leaves no stone unturned.”

She was right. I agreed with her sentiment then, and I still do, but she no longer appears to agree with herself.

[Sir Peter Bottomley (Worthing West) (Con)]

I think we understand the point that the judgment was about the timescale, and not all the contracts meeting the regulation. It would be good for the House to hear how much of the supply of PPE now comes from this country, rather than from abroad. If I was Minister at the time, and officials told me that we could either get more ventilators and PPE, or ensure that we did not fail to meet any of the regulation timescales, I would have said, “As Minister, I will take responsibility for the failure on the timescales; you can take responsibility for getting the equipment that people need.”

[Edward Argar]

I am grateful to my hon. Friend. In answer to his first question, at the start of the pandemic, roughly 1% of the PPE used in these settings was produced in this country. Due to the incredible efforts of businesses and individuals across the country—and, I must say, of civil servants and officials in Government, who are often the unsung heroes of the pandemic—up to 70% is now being supplied by this country. He is absolutely right that transparency is important. It is hugely important, and we respect it and take it very seriously, but I make no apologies for what I and the Secretary of State consider to be the most important thing, which is doing whatever is necessary to save lives in the course of this pandemic.

[Stewart Hosie (Dundee East) (SNP) [V]]

I am glad the Minister mentioned transparency, because of the £15 billion PPE contracts awarded up until last October, barely £3 billion were properly published, and we had £252 million given to a finance company, £108 million to a confectionery supplier and £345 million to a pest control company—a catalogue of cronyism, described variously as a “wholesale failure”, a “dismal failure” and a “historic failure”. It was a process that deprioritised compliance and has ended up with the taxpayer, in some cases, buying expensive and unusable PPE. Ultimately, the Cabinet Office is responsible for the co-ordination of the cross-Government response to covid-19. So let me ask the Minister when the Minister for the Cabinet Office and, indeed, the Prime Minister were first made aware that failure to properly publish details of PPE contracts might be unlawful?

[Edward Argar]

I am grateful to the right hon. Gentleman. He will appreciate that some of the contracts which some colleagues have alluded to remain subject to separate litigation before the courts, including some by the Good Law Project, which I will refer to as the GLP as I suspect it may come up a number of times and it might save a few minutes in my answers. I hope he will understand that I will avoid straying into something that may still be before the courts, because I do not want to show any disrespect for the legal process. He talked about the number published and where we have got to now. That will be some of the information put before the judge on Friday as per his request, but for the latest figures that are in the public domain, which were covered in the judgment and indeed more broadly, I think 100% of the contract award notices have been published, and we are up to 99% under regulation 108 on the latest figures I have. As the judge said, the overall picture does show the Secretary of State

“moving close to complete compliance.”

In respect of the right hon. Gentleman’s broader point, I would expect that Ministers in my Department—which is why I am here—as well as Ministers in the Cabinet Office, will have followed the process very closely.

[Mr William Wragg (Hazel Grove) (Con)]

I welcome my hon. Friend to the Dispatch Box. I hope that the Chancellor of the Duchy of Lancaster was not too indisposed cooking up plans for the domestic covid passports that he had previously ruled out to attend the House today. Most fair-minded people will look at this situation in the round and perhaps give the Government the benefit of the doubt, because the judgment found against the allegation of a secret deprioritisation policy to deliberately breach procurement rules.

Further to the question from the Father of the House, my hon. Friend the Member for Worthing West (Sir Peter Bottomley), can my hon. Friend the Minister give greater detail of the extent of the increase in domestic production of PPE in this country so that we have security of supply?

[Edward Argar]

My hon. Friend is absolutely right. I believe that officials did do the right thing in prioritising getting the PPE that we needed for our frontline, and he is also right to highlight an aspect of Justice Chamberlain’s judgment, which found there was no policy of deprioritising the publication of contract notices and data. On his final point, I said to the Father of the House that we have moved from 1% domestically produced PPE to 70% now. To put that in context, we have supplied 8.6 billion items, and we have more than 30 billion on order or being supplied at present. I suspect that as my hon. Friend is a former teacher, albeit a history teacher, his mental arithmetic is probably more rapid than mine in calculating that proportion as an absolute number, but I hope it illustrates to him just how much we have moved in the past year to utilise the fantastic resource we have in manufacturing in this country.

[Sarah Owen (Luton North) (Lab) [V]]

Covid contracts continue to be literally a matter of life and death, so the public are right to expect accountability and transparency. While nurses wore bin bags instead of proper PPE, contracts were handed out to Ministers’ mates. Will the Minister do the right thing and, at the very least, reveal the 29 businesses Serco outsourced operations to?

[Edward Argar]

We have been clear, and as I highlighted earlier, the NAO has been exceptionally clear, that there are no suggestions of Ministers behaving inappropriately in any way in the awarding of these contracts. The judge did not find that in this case; it was not a factor. On the hon. Lady’s broader point, we have been clear that we believe in and fully respect transparency requirements, and the Department is publishing—as I illustrated with those latest figures that I put out earlier—the contracts it has. I once again come back to the judge’s saying that the Secretary of State is

“moving close to complete compliance.”

That is exactly what we will continue to do.

[Antony Higginbotham (Burnley) (Con) [V]]

At the height of the pandemic last year, the priority for the whole country was getting PPE to where it was needed—on the frontline. I received offers of help from many businesses that I fed into the Department. Will the Minister confirm how many items of PPE have been delivered because of these contracts that came in over the course of last year?

[Edward Argar]

I am grateful to my hon. Friend. As I said, contracts secured by the Department since the start of the pandemic have delivered 8.6 billion items, and around three times that number have been ordered to ensure that we continue to have a robust supply, to ensure that our frontline health and social care and other workers have the PPE they need to protect them, which is the most important thing in this situation.

[Caroline Lucas (Brighton, Pavilion) (Green) [V]]

Both the Health Secretary and the Prime Minister have repeatedly claimed that all the information relating to PPE and other covid contracts is published online, so will the Minister tell us specifically where to find details about the VIP lane, including who the entrants were, what they were paid and who introduced them? On behalf of the Government, will he apologise to the numerous NHS and care staff who have been deeply upset by comments made by the Health Secretary yesterday—echoed by himself today—that there was not a shortage of PPE? Does he understand why that is so insulting to the doctors who were forced to wear bin bags in the absence of gowns and to the nurses who were wearing goggles from Screwfix?

[Edward Argar]

As I highlighted to the hon. Lady, we are at 100% compliance on contract award notices. The Prime Minister was referring to the obligation to publish, and that is what we have done. Although the judge ruled that the hon. Lady had no standing to bring this case, I appreciate her long-standing interest in this matter. In respect of her point about the supply of PPE, as the NAO report highlighted, we did not run out of PPE nationally. That is not to say that there were not significant challenges in some hospitals in some areas regarding the distribution of that PPE. That has been acknowledged throughout this pandemic. Our frontline health and social care workers did an amazing job in challenging circumstances, and civil servants across my Department and others worked flat out, day and night, doing an amazing job to get the PPE that was needed.

Finally, I know that transparency and the timely publication of the data are important to the hon. Lady. I highlight one of her own Green councillors in Brighton and Hove who, in a recent written answer on that council’s failure to publish its financial spending figures since, I think, last June, said that the council

“quite rightly, prioritised paying our suppliers and providers as quickly as possible”,

and that it was

“prioritising payment of suppliers and providers over production of this information.”

[Mr Speaker]

Order. I think we need to try to keep to the questions, not score points. Let us go to Aaron Bell, who will not want to score a point.

[Aaron Bell (Newcastle-under-Lyme) (Con) [V]]

As my hon. Friend just did, I note from the judgment that Mr Justice Chamberlain found that the three Members of Parliament who sought to join this case did not have standing. In paragraph 107, he stated:

“In a case where there is already a claimant with standing, the addition of politicians as claimants may leave the public with the impression that the proceedings are an attempt to advance a political cause”.

Does my hon. Friend agree that this recent practice of trying to extend politics through court cases is becoming quite damaging to our democracy as a whole, particularly when technical judgments are then deliberately misrepresented, as seems to have happened in this case?

[Edward Argar]

I am grateful to my hon. Friend for what he has said. As a former Justice Minister, I have huge respect for the legal process and, indeed, for the judgment of the courts, but he is right to highlight once again the point that the judge made in his finding that the Members of this House who sought to bring this case had no standing in doing so and that it was the GLP that did. Although I appreciate that Members of this House feel strongly on this issue, and understandably so, I echo his point that I hope they do not seek to use the courts to make political points but rather to use them for what they are there for, which is to highlight legal issues.

[Bell Ribeiro-Addy (Streatham) (Lab) [V]]

The scandal surrounding covid contracts has not just been about the lack of transparency, but about the poor performance of these companies: £350 million to PestFix for PPE that did not meet the required standards; another £347 million to Randox, which had failed on its original £133 million contract by distributing test kits that were not sterile; and, of course, the millions to Serco and others that failed with the track and trace system. Does the Minister agree that all public sector contractors should be held to the highest standard, no matter who their friends are, and will he outline what plans the Government have to hold such contractors to account and recoup millions of pounds of public money, or will he uphold these standards depending on whether the contractors have links with the Conservative party?

[Edward Argar]

On the hon. Lady’s first point, a number of specific cases relating to specific contracts remain before the courts, so if I may I will address her broader point about pursuing the appropriateness of the contractors—whether they could deliver—where they failed to deliver to the appropriate standards, and what steps the Government will take. All contracts were assessed against the eight criteria for appropriateness, including due diligence, safety standards, and whether they meet the specifications and so on. If any contractor did not deliver against that, we will either refuse to pay or we will be seeking to recoup that money, and a number of investigations are already under way to fulfil that commitment.

The hon. Lady also touched on and made a very particular point about Serco—I should have answered this point when the shadow Minister mentioned it, so I hope she will forgive me for coming back to it now. Let me make one point, which I hope the hon. Member for Streatham (Bell Ribeiro-Addy) will be aware of, and I am sure she was not suggesting anything to the contrary. As was made very clear on the “Today” programme last year, I had no involvement with those contracts in any way, shape or form. Although I left the company seven years ago, although I was never a director of that company, and although I have no ongoing links with it, so there would have been no conflict, I none the less had no involvement at any point or at any level with those contracts and I continue to adopt that position. I hope that that is helpful to her in clarifying that point.

[Jonathan Gullis (Stoke-on-Trent North) (Con) [V]]

The British people want us to keep on fighting this virus, protecting our NHS as we roll out the vaccine and saving lives. Does my hon. Friend agree that sniping from the side lines, as the Labour party is doing, is the opposite of what the people of Stoke-on-Trent North, Kidsgrove and Talke want to see right now in these unprecedented times?

[Edward Argar]

I recognise that all Members of this House and all members of the public in our constituencies want transparency, and quite rightly so, but what is most important to them in the midst of this pandemic and as we emerge from it, is to know that this Government and those who work for them have done everything they can to ensure that we procured the PPE that was necessary, when it was necessary, to protect the frontline and help save lives.

[Layla Moran (Oxford West and Abingdon) (LD) [V]]

Whether I have standing or not, I am proud to have helped bring this case, alongside the hon. Members for Brighton, Pavilion (Caroline Lucas) and for Oldham East and Saddleworth (Debbie Abrahams). We did it because we could not get the information through the normal channels in this place. It is also worth noting that, rather than simply admit the breach and then promptly publish all contracts at the beginning of the process, the Secretary of State for Health and Social Care chose to push the case to court and then, when he lost, said that he would break the law again. At the heart of the case was always transparency and fairness. Many established businesses felt frozen out because they happened to not be chums with a parliamentarian or a Minister, so my question is this: can the Minister not see how this looks, and can he also not see how delays in publishing these contracts in good time further undermine trust in Government, at a time when trust, as much as PPE, is necessary for saving lives?

--- Later in debate ---

[Edward Argar]

Although I made the legal point about lack of standing, I hope that the hon. Lady heard me highlight and acknowledge the fact that she and two other hon. Members clearly have an interest in this, and that she has long-standing interest in this issue and this case. She is right to highlight trust; I think what is central to the trust of the British public is the Government doing everything they can to deliver for our frontline workers the protection they needed to make sure they could keep protecting us safely.

The Secretary of State highlighted at the weekend—I think this is the latest figure—that the publication of notices was, on average, 17 days over the 30 days required. I do believe it is important that transparency is adhered to, but I also remind the hon. Lady that it is extremely important to highlight why this happens. That is why we filed the court papers and defended the case as we did, because it is hugely important for the Court to see why this occurred. The Government continue to do what I believe the public expect us to do: focus on protecting the frontline.

[Craig Whittaker (Calder Valley) (Con) [V]]

Many excellent companies in the Calder Valley that would not normally bid for Government contracts have stood up for the national effort, and have been making PPE for the national cause even when this is not their core business. This has secured jobs, secured business, and ensured our NHS has had the PPE when it needed it. Can my hon. Friend confirm that all these, and other, Government contracts were awarded in a fair, open and transparent way, following due process, and that this Government have remained committed to publishing them as quickly as possible, even under the pressures of the pandemic?

[Edward Argar]

I am grateful to my hon. Friend, and like him, I pay tribute to all those businesses and individuals who stepped up in this country’s moment of need, and were willing to put themselves forward and repurpose their factories to try to find ways to help that the national effort. All the contracts have been found so far to be awarded entirely appropriately; there has been no adverse judgment in respect of any of that. Indeed, regulation 32 highlights that in an emergency, contracts can be awarded without tender, and I certainly take the view that the situation we face with this pandemic constitutes a national emergency.

[Hannah Bardell (Livingston) (SNP) [V]]

Can the Minister tell me whether it is coincidence, incompetence, or just rank stupidity that his Government and Health Secretary awarded a £30 million contract for testing vials to the Health Secretary’s former neighbour, a former pub landlord who had no experience in this field and is now being investigated by the Medicines and Healthcare Products Regulatory Agency? Surely, the Minister agrees that these breaches mean the Health Secretary must resign.

[Edward Argar]

The hon. Lady will not be surprised to know that I completely and utterly disagree with her. I think my right hon. Friend has done, and continues to do, an extraordinary job under extraordinary pressure to help this country through this pandemic over the past year.

The hon. Lady raised a very specific issue. It has been made clear that neither the Health Secretary nor any other Minister had any involvement in the assessment, the due diligence, or any decisions in respect of that contract.

[Sir Robert Neill (Bromley and Chislehurst) (Con) [V]]

The judge very clearly found that there was a breach in relation to one matter: the 17-day average delay. He rejected the suggestion that there was a systematic failure. He rejected the suggestion that there is any impropriety in the system for awarding the contracts and did not impugn any of the contracts themselves or the process by which they were awarded. Most lawyers would know that this was a technical breach, as it has been described, albeit a breach. Is not the real moral of this that when those of us in politics seek to comment upon judgments, it is a good idea to actually read the judgment first and understand the law on which it is based, rather than grandstanding inaccurately, as has too often been the case here?

[Edward Argar]

I am grateful to my hon. Friend for his comments. He is absolutely right to highlight what this judgment actually said. It found, in what had to be a binary judgment—either it was complied with or it was not—that the Government failed to comply with the 30-day publication timing for all contracts. He is right: the judge rejected the suggestion of any policy of deprioritisation. I read the 40 pages of Justice Chamberlain’s judgment, including the setting out of the different cases put by the two parties, the discussion of it and then, crucially, his findings on it. I would advise all Members who take an interest in this issue to do exactly the same thing, because legal judgments are rarely as clearcut or as simple as some commentators and others might wish to suggest.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab) [V]]

The Government’s infatuation with private sector delivery of pandemic public services has led them to ignore basic procurement best practice, replacing value for money with cronyism and due diligence with pub pals. Will the Government commit, as Labour has done, to a programme of insourcing and start by handing over the failing Serco test and trace to the public sector, which has made such a success of the vaccine delivery?

[Edward Argar]

On the hon. Lady’s main point about private and public and, I would add, voluntary sector organisations, every one of those has stepped up and made a hugely important contribution to our country’s response to this pandemic. I wish to pay tribute to public sector organisations. I spent 10 years as a councillor, and I entirely recognise the amazing work they do. I pay tribute to private sector organisations, which have also stepped up for our country, and to voluntary sector organisations. For me, it is not an either/or; it is both, and it is about what delivers the best outcome for the public. Anything less would be letting down our constituents and letting down our public services.

[Angela Richardson (Guildford) (Con) [V]]

At the height of the pandemic, the contracts we signed allowed us to stand side by side with the private sector, procuring enormous volumes of goods and expertise with extreme urgency. Does my hon. Friend agree that without these vital contracts, our covid response would have suffered as a result?

[Edward Argar]

I agree entirely. Some of the narrative around this reminds me slightly of my days back at school and “Animal Farm”—“Four legs good, two legs bad.” The reality is that both private sector and public sector have played an incredible role in tackling this pandemic, for which we should be extremely grateful. We need both, and we need both to continue delivering in the public interest, which is what we have secured.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

A couple of points seem to be coming up from this discussion. The first is that there were no shortages of PPE. That is patently not true. We have clear evidence that that was the case, not least from Exercise Cygnus back in 2016, but also from constituents working in the NHS who have reported this directly to me and to colleagues. The second is that the Government have published all the contracts, and the Minister has made reference to 100% of contract award notices being published. Unfortunately, we are not able to verify that. That is the key point made by the NAO, which said that there are still £4 billion-worth of contracts since November 2020 where we have no idea who they have gone to or how much for. Once again, will the Minister commit to publishing these VIP contracts, how much they were for, who they were awarded to and what for?

[Edward Argar]

The hon. Lady and I have known each other for a long time and she made her point forcefully but, as ever, fairly. She raised a number of points. In respect of PPE supplies, as I made clear to the hon. Member for Brighton, Pavilion (Caroline Lucas), the NAO report—I believe from last November—said that supplies did not run out nationally, but as I have clarified that is not to say that there were not local shortages and challenges in individual trusts, as I acknowledged to the hon. Member for Brighton, Pavilion. That is why we procured as much as we could as quickly as we could.

The hon. Member for Oldham East and Saddleworth (Debbie Abrahams) raised Exercise Cygnus, which has come up a number of times. It is important to remember that Exercise Cygnus did not look at tackling a novel pandemic; it looked at influenza specifically. The PPE required for dealing with a disease of covid’s nature is very different from that required for flu. That exercise had, as one of its predicated actions, the swift arrival of antivirals to be delivered to tackle the flu; such antivirals did not exist until much later in the case of covid. It is important that we learned from Exercise Cygnus, but we should be careful about reading it directly across as representing a blueprint for how to tackle a pandemic of this sort.

On the hon. Lady’s final point about transparency, as I have made clear, the Government remain committed to transparency and to the publication of contracts, as required under the regulations.

[Holly Mumby-Croft (Scunthorpe) (Con) [V]]

At the height of the first wave of the pandemic, we looked to the Government to procure and distribute tens of thousands of critical items of PPE in Scunthorpe. Does my hon. Friend agree that the Government should of course remain committed to following all the detail of procurement rules, but that protecting our frontline health workers should always come first?

[Edward Argar]

I agree entirely with my hon. Friend. It should not have to be an either/or, but we all remember the conditions in which our amazing civil servants were working at pace back at the start of this pandemic. They were working flat out and they included, as was acknowledged in the Court papers, civil servants who were not Department of Health and Social Care civil servants but were seconded from other Departments to work on different systems just to get that PPE ordered and delivered to protect the frontline, which was the priority. It should not be an either/or, but my hon. Friend is absolutely right that at the height of that first wave, it was absolutely right that the focus of those dedicated officials was on getting the PPE that we needed.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind) [V]]

I am not an expert in public procurement, but even in an emergency I would expect that diligent contracts would include full payment-on-delivery clauses or clawback measures for failure to supply. The Minister mentioned in an earlier reply that the British Government are pursuing contractors who have failed to meet their obligations. How much public money has been regained to date? Will he ensure that the House is updated on the Government’s efforts to recoup misspent public money?

[Edward Argar]

The hon. Gentleman is absolutely right to highlight the fact that if contracts do not deliver, either to standard or not at all, public money should either not be paid or be recouped. We are currently going through a number of investigations to deliver exactly that, and I am happy to commit that at the appropriate juncture we will of course update the House.

[John Howell (Henley) (Con) [V]]

Does the Minister accept that illegal acts are those that contravene the law and that unlawful acts are those that contravene the rules? A handball in soccer is unlawful, not illegal. Does he accept the point made by the Chairman of the Justice Committee, my hon. Friend the Member for Bromley and Chislehurst (Sir Robert Neill), that this was a technical breach that has been overcome, and that the Department is going out of its way to make sure that that happens quickly?

[Edward Argar]

I suspect I can do no better than to quote the judgment, which stated that in respect of regulation 50 the Government “acted unlawfully”, but my hon. Friend is right to highlight the fact that—again, as the judgment set out—the Secretary of State is almost at complete compliance, which is exactly what the Government are committed to.

[Liz Twist (Blaydon) (Lab) [V]]

The Government claim that this is just a case of a few PPE contracts being published a couple of weeks late, but in fact we know that hundreds of millions of pounds-worth of contracts also went to management consultants. Will the Minister confirm whether all the contracts for which the publishing deadline was missed, from the start of the pandemic until now, were in fact for PPE, or did they also include contracts that have gone to private consultants? Will he explain why those contracts were not published on time?

[Edward Argar]

My understanding is that this data relates to all contracts by the Department. If I am inaccurate in that, I will of course correct the record for the House, but my understanding is that this data refers to all contracts by the Department itself.

[Stephen Metcalfe (South Basildon and East Thurrock) (Con) [V]]

Can my hon. Friend confirm that all Government contracts are awarded in a fair, open and transparent way following correct due process, and that this Government remain committed to publishing them as quickly as possible, even under the pressure of this pandemic? Does he agree that the public are much keener that we address the real issues of the pandemic than engage in political point scoring?

[Edward Argar]

I could not agree more with my hon. Friend, about both the Government’s commitment to transparency and to publishing contracts within the regulations, and in reminding everyone about where we were a little under a year ago, and the absolute focus by so many amazing and dedicated civil servants on getting the PPE we needed and getting it in quantity.

[Owen Thompson (Midlothian) (SNP) [V]]

The United Nations Office on Drugs and Crime says in its “Recover with Integrity” campaign that emergency responses

“must be anchored in law and be implemented by strong public institutions, with the involvement and under the oversight of members of parliament, anti-corruption bodies, civil society and the private sector.”

It is clear that hon. Members have numerous questions on these contracts, so will the Minister now advocate such action as backing my Ministerial Interests (Emergency Powers) Bill to make sure that Parliament can scrutinise the Government’s actions and that Members of this House and the public can be confident that there is no suggestion of any corruption taking root?

[Edward Argar]

I would rebut any suggestion that there is any corruption taking root, to use the hon. Gentleman’s words. Members of this House have the ability to ask questions and the NAO has the ability to ask questions. The hon. Member for Hackney South and Shoreditch (Meg Hillier) will, I suspect, ask me a question in a moment, but she also has the ability to ask questions in the Public Accounts Committee, which she chairs, which, I believe, took evidence for three and a half hours in December from various senior officials in the Department. I am aware of the hon. Gentleman’s Bill, which I am sure the Government will look at in the usual way.

[Scott Benton (Blackpool South) (Con) [V]]

At the start of this pandemic the British people rightly expected the Government to leave no stone unturned in securing the vital supplies of PPE that were needed to fight the pandemic. Does the Minister agree that the findings from the National Audit Office make it clear that while we were in the grip of the global shortage of PPE, no health trust ran out of supplies at any point, and that that was thanks to the contracts that the Government managed to secure?

[Edward Argar]

I am grateful to my hon. Friend. We did take every step we could to ensure that trusts had the PPE they needed. The NAO report said:

“The NHS provider organisations we spoke to told us that, while they were concerned about the low stocks of PPE, they were always able to get what they needed in time.”

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

I will touch on that point first. Paragraph 18 of the summary says exactly what the Minister said, but it then goes on to say, however, that frontline workers reported shortages of PPE. It does not behove him well to come to this House clearly having had Back Benchers briefed about a partial element of the National Audit Office’s report that is inaccurate when taken in the round. He needs to deal with that point.

My bigger point is on the transparency of the contracts. The Minister has talked breathlessly about the urgency at the early stage of the pandemic. Let us be clear: by the end of the summer and the autumn, many of the contracts had still not been published. The civil service is usually good at record-keeping and transparency, but on this occasion there was a failure. He should have the guts to come to the House, apologise, and promise it will not happen again. More transparency, not less, is vital when billions of pounds are being spent, in haste in a pandemic.

[Edward Argar]

I am grateful to the hon. Lady, who knows this issue exceptionally well and has investigated it over a number of months. Of course, as always, I listen to what she says carefully and with considerable respect. On her first point, she is right to say that the NAO reported that some frontline workers had told it that they had experienced shortages. We are reflecting what we were told by our trusts and by those running the delivery of PPE in those trusts, and what the NAO was told by them. She alluded to the key point—as I believe I said in response to the hon. Member for Brighton, Pavilion (Caroline Lucas)—that we did not run out of PPE nationally, but there were challenges, which I acknowledged and do acknowledge, at some individual trusts and in some localities. That is why we worked at pace to make sure that they got what they needed and did not run out of PPE. That is exactly why officials in the Department were working so hard and pulling out all the stops to make sure we ordered more PPE and got more of it delivered.

The hon. Member for Hackney South and Shoreditch made a broader point about transparency, and of course it is a vital point. I believe it was the hon. Member for Oxford West and Abingdon (Layla Moran) who highlighted trust. Trust is always the currency of politics; it is always the one thing that everyone requires, in government and in this House. It is important that that is fostered by as much transparency as possible. The judgment found that in a number of cases the Government did not meet the 30-day deadline. The hon. Member for Hackney South and Shoreditch asks for an assurance now, and I can give her the assurance that the Government are doing everything they can to ensure that regulation 50 is complied with, and complied with fully.

[Selaine Saxby (North Devon) (Con) [V]]

The British people want us to focus on fighting this virus, so that we can protect our NHS as we roll-out the vaccine and save lives. Does my hon. Friend agree that the political sniping some of the Opposition are engaging in is the exact opposite of what people expect and want to see politicians doing?

[Edward Argar]

I think what my constituents and the British public want to see us all doing is working together to make sure we get through this pandemic and get those on our frontline what they need to keep them safe.

[Peter Kyle (Hove) (Lab)]

There are 60,000 pub landlords in this country and many of them have lots to give in a time of crisis, but is it not a coincidence that the one who gets a massive contract happens to be the one who has the mobile phone number of the Health Secretary? There are hundreds of racehorse owners in this country. Is it not funny that it just so happens that the one who gets a top job, without the need for an interview, happens to be a mate of the Health Secretary? And on and on it goes. If this behaviour was going on in a country in the developing world, there would be howls of “Corruption!” from those on the Tory Benches and calls for the aid budget to be cut. Is it not true that, when it comes to jobs for friends, dodgy contracts and all the rest that has been going on which has been normalised by this Government, they and the Tory party have a blind spot?

[Edward Argar]

Again, I have huge respect for the hon. Gentleman, who is normally measured and tempered, but I fear on this occasion that he has not done himself justice in the points he makes. As I have made clear, and as has been made clear, all contracts that were awarded were assessed by an eight-stage process run by the civil service—checking due diligence, appropriateness, ability to deliver and price—and not by Ministers. On the specific contract he mentioned, it has been made clear that the Secretary of State had no involvement in the award of that contract or its assessment.

[John McDonnell (Hayes and Harlington) (Lab) [V]]

I think the whole tenor of the discussion today demonstrates a need for greater transparency, as the Minister has said. One way of doing that is by extending freedom of information to include all companies engaged in publicly funded contracts. I am concerned about the data contract with the US data company Palantir, which is notorious for its links with Trump and the white supremacist far right. Will the Minister confirm whether that contract has been the subject of a data protection impact assessment, including a public consultation, and whether Palantir will be able to sell on NHS data at a later stage, even, for example, to the Conservative party for electoral purposes?

[Edward Argar]

I will not stray near the wilder accusations made by the right hon. Gentleman. What I will say to him is that the data of NHS service users is always protected by this Government.

[Bob Blackman (Harrow East) (Con) [V]]

I am a great believer in competitive tendering to gain the right value for money for the public sector. At the height of the first wave of the pandemic, my local hospital, Northwick Park, came perilously close to being overwhelmed by the number of patients and by having only one day’s supply of PPE within the hospital. Thanks to Government actions and the Department of Health and Social Care, that was remedied. What does my hon. Friend think would have happened if the Government had decided to competitively tender all those items and wait potentially three months before the supplies were available?

[Edward Argar]

My hon. Friend highlights the work of his fantastic hospital at Northwick Park and the fact, which I alluded to in response to the Chair of the Public Accounts Committee, that while we did not run out of PPE nationally, there were some real challenges at a number of sites. They did an amazing job to ensure that they had the PPE they needed. I believe the minimum time it can take to run a tender is around a month, and I certainly would not have wished to see us not utilising regulation 32 and waiting a month to order and secure the PPE that his hospital and those working in it needed.

[Ruth Jones (Newport West) (Lab) [V]]

The people of Newport West have looked at the media reports, the court judgments and the answers given in this House on this matter with horror. There appears to be no respect for honest, law-abiding citizens who play by the rules, and that is unacceptable, so when will Ministers finally show their respect for the will of the people and the ruling of the court and stop this reckless behaviour?

[Edward Argar]

I have made it clear that I and Ministers always respect the courts and the judgments delivered in them. I also have great respect for, and recognise the importance of, transparency. I would say to the hon. Lady, however, that I also respect the need to rapidly deliver the PPE that was needed last year at the height of the pandemic, which is what our constituents would expect us to do. As we cast our minds back, I think that is what they would have wanted us to focus on at that time. On her final point, yes I am quite happy to restate the Government’s commitment to the importance of transparency.

[Hywel Williams (Arfon) (PC) [V]]

Using the VIP lane, a PPE contract for £313 million was awarded to PestFix, a company that had never before supplied medical PPE. To put this fantastical sum into perspective, a free school meal every day for a year for every child in Wales in a family getting universal credit would cost £101 million —less than a third of the sum gifted to PestFix. Given the Minister’s unapologetic replies so far, does he even begin to understand why the perception of his Government’s default cronyism has angered so many people?

[Edward Argar]

I am grateful to the hon. Gentleman. I will not comment on specific cases because, as I mentioned at the beginning, some are still subject to actions before the courts and I do not want to cut across those legal processes. The broader point I would make is that I think people will understand that this Government and the unsung heroes of the pandemic—the civil servants and officials who have worked throughout it—pulled out all the stops to do what was necessary and essential to procure the PPE. If we look back 10 months or so, it was the most pressing issue in this country to ensure that our frontline workers got the protection they needed.

[David Simmonds (Ruislip, Northwood and Pinner) (Con) [V]]

When I reflect on my inbox from nearly a year ago, I remember that my constituents were expressing huge anxiety about access to personal protective equipment in nursing homes and medical establishments, so will my hon. Friend accept the thanks of my constituents for having acted so swiftly to ensure that the necessary essential equipment got where it needed to be? Does he share my frustration that that success is being overshadowed by the frankly dubious attempts to muck-rake in respect of the process that was undertaken?

[Edward Argar]

The equipment was procured, it was secured and it was delivered. It did what we would all have wished it to do: it went to the frontline to protect people and to ensure that hospitals and trusts did not run out of PPE at that crucial point in the first wave. My hon. Friend is absolutely right to highlight what I believe the British public would have wished to see us doing, which was focusing on getting the PPE to those who needed it as fast as we could in that crisis.

[Wendy Chamberlain (North East Fife) (LD)]

The Committee for Standards in Public Life is currently undertaking an inquiry focused on the upholding of the Nolan principles of public life, which include integrity, accountability and openness. Given that it has been reported that civil servants delayed publications at the behest of No. 10 special advisers, and given that we have ended up in a situation where this matter has been taken to court, does the Minister believe that the Government have met those standards?

[Edward Argar]

I am grateful to the hon. Lady for her question, but in answer I revert back to what the judge, Mr Justice Chamberlain, said in his findings in this case: he found no evidence of a policy of deprioritisation of meeting transparency requirements on publication.

[Marco Longhi (Dudley North) (Con) [V]]

My Dudley North constituents, like me, can see right through this urgent question for its petty political intent. For the avoidance of doubt, will my hon. Friend confirm how many people came to harm because this paperwork was two weeks late, compared with the harm that would have arisen from PPE and medical equipment being received two weeks late?

[Edward Argar]

Transparency is important. The Chair of the Public Accounts Committee and others have rightly made that point, but saving lives is important and, I would argue, in the height of the pandemic, more important. It was right that civil servants and others focused entirely on that purpose of getting the PPE to reduce the risk of loss of life, and as the judge acknowledged, they have worked very hard subsequently to catch up with the transparency requirements to ensure that the information is published and is available for interrogation.

[Matt Western (Warwick and Leamington) (Lab)]

As they say, if it smells of fish, it is fish, but in this case it is like Billingsgate market. When it comes to Government contracts, someone is 10 times more likely to get one if they have a Government contact. The protocols are clear, as the Supreme Court confirmed, and the Health Secretary acted unlawfully in not revealing the details of contracts with his pub landlord, a hedge fund in Mauritius or the jeweller in Florida, yet there was insufficient PPE available in our social care system. As the NAO said, it was 10% of what was required. For our frontline health workers, there was just not enough FFP3. The Minister says that trust is vital, but is it not the truth that Ministers’ mates and their suppliers in China have been favoured in supplying PPE over UK companies such as Tecman and Contechs in my constituency?

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. That was a very long speech. I do not want the hon. Gentleman to create a precedent.

[Edward Argar]

I am grateful to the hon. Gentleman for his initial analogy. He made a couple of points there. I believe—this is from memory, so forgive me if I am slightly out, and I will correct the record if I am—that around 90% of those bids that came through the high-priority lane were rejected. They were carefully assessed by civil servants against the eight stages of the procurement process set up to ensure that due diligence was followed.

The hon. Gentleman raised a very specific point, which I want to address, because he talked in his question not just about NHS trusts, but quite rightly about those working on the frontline in social care settings and the PPE they needed. He quotes accurately, if my recollection is correct, from the NAO report. One of the factors here was that traditionally, social care settings are private businesses in most cases and procured their PPE directly in private contracts with their suppliers. That is one of the reasons why, as I mentioned in my opening remarks, during the early phase of the pandemic we moved from supplying 226 trusts with PPE to making that service available to 58,000 or so settings to get PPE to social care. That was a reflection of the Government’s commitment and work to make sure that we could use centralised procurement and centralised supply to help support the social care sector get what it needed.

[Jacob Young (Redcar) (Con)]

I commend the Government for their efforts to do whatever it took to protect the frontline during the height of the pandemic. Will the Minister join me in extending our thanks to the amazing NHS workforce and the armed forces personnel working at James Cook University Hospital and Redcar Primary Care Hospital, as well as our teams in primary care, without whom we would not have vaccinated 18 million people?

[Edward Argar]

I am very happy to join my hon. Friend in doing that. I suspect that, in what has been a contentious urgent question, that is a point on which there will be consensus between me and the shadow Minister. We pay tribute to those working on the frontline of our NHS and social care, and those helping with the vaccination programme.

[Jim Shannon (Strangford) (DUP)]

Does the Minister share my view that, although transparency is important, saving lives is even more important, and that the public servants who have done much to secure the vital supplies of protective equipment that we need deserve our praise, not criticism? Will he clarify that the information required by the judicial review judgment will be revealed in a timely manner?

[Edward Argar]

I am grateful to the hon. Gentleman, who is absolutely right to pay tribute to the officials and those who were working flat out at the height of the pandemic, often through the night and at weekends. Even when working from home, they did not see much of their families because they were working incredibly hard to procure the PPE we needed to keep people safe. I pay tribute to them. On the hon. Gentleman’s final point, my understanding is that the additional information required by the judgment must be supplied to the court by Friday, and I expect that the judge will make that public.

[Mike Wood (Dudley South) (Con) [V]]

Speed is vital during a public health emergency, but transparency remains important. What assurances can my hon. Friend give us that, although paperwork can never come before delivering essential medical equipment and services to the frontline, the Government are committed to publishing contracts in a timely manner to ensure that my constituents in Dudley South can have confidence that the processes are fair, open and transparent?

[Edward Argar]

I thank my hon. Friend. He is absolutely right. Getting PPE to the frontline, procuring what we needed and getting it delivered was the absolute priority. As I have expressed throughout my remarks, I recognise that transparency is hugely important, and we will supply the court with the further information it needs. As the judge said, we are now virtually in complete compliance, and we will continue to work hard to ensure we comply with the requirements under regulation 50 and the other requirements of the Public Contracts Regulations 2015.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I will now briefly suspend for a few minutes in order that arrangements can be made for the next item of business.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Mark Pawsey (Rugby) (Con)]

What steps he is taking to ensure that improvement work on district hospitals is taken forward under the health infrastructure plan.

[The Minister for Health (Edward Argar)]

Alongside our investment in 40 new hospitals, our health infrastructure plan more broadly will deliver a long-term rolling programme of investment in health infrastructure, including our vital district hospitals—I know that my hon. Friend’s constituents are well served by the Hospital of St Cross. Hospitals have benefited from more than £600 million of critical infrastructure risk funding, including for district hospitals, and will shortly receive their capital allocations for the forthcoming financial year.

[Mark Pawsey [V]]

I am grateful to the Minister for his reply. As he says, it is entirely right to be investing in the new hospitals—the 40 new hospitals for our NHS. He referred to our brilliant local district hospital, St Cross. The past year has reminded us of the importance of a well-resourced local health service. How can we ensure that existing district hospitals doing great work, such as St Cross, continue to receive the investment they need?

[Edward Argar]

I am grateful to my hon. Friend for his question. May I join him in paying tribute to his local Hospital of St. Cross and the team who have done an amazing job in very challenging circumstances over the past year? I know that he is a strong champion of it and of his local NHS—I think I can recall him volunteering at the Locke House vaccine centre recently in support of his NHS. Of that critical infrastructure funding to which I referred, £2.2 million was allocated to his trust and local hospital. As I mentioned in my initial answer, we will be making further capital allocations shortly, which will benefit district hospitals, including his own.

[Siobhan Baillie (Stroud) (Con)]

What steps his Department is taking to support people suffering from long covid.

--- Later in debate ---

[Andrew Jones (Harrogate and Knaresborough) (Con)]

What progress his Department has made on improving the health service capital estate.

[The Minister for Health (Edward Argar)]

A total of £600 million has been allocated to tackle almost 1,800 urgent maintenance projects across 178 trusts, all due for completion by March 2012, while £450 million has been invested to upgrade A&E facilities, with funding awarded to over 120 trusts, and improve over 190 urgent treatment sites this winter. In addition, of course, the Prime Minister has confirmed that 40 new hospitals will be built by 2030, with an additional eight further schemes to be identified. Six of these are already under construction. With your permission, Mr Speaker, may I group this question with Question 21?

[Jo Gideon [V]]

NHS staff at Royal Stoke University Hospital in my constituency have been using the old Stoke Royal Infirmary site, which stopped delivering clinical services in 2012, for car parking. However, with the demolition of buildings on the site in readiness for the creation of many new houses, hospital staff really need the University Hospitals of North Midlands NHS Trust’s proposed plans for a multi-storey car park to come to fruition. Will the Minister ensure that the necessary investment is forthcoming for additional staff car parking facilities at Royal Stoke University Hospital to support our wonderful NHS staff and unlock this vital regeneration project for the people of Stoke-on-Trent?

[Edward Argar]

I am very grateful to my hon. Friend, who is a strong champion and a strong voice for Stoke and for her local hospital. The Government are committed to increasing hospital car parking capacity and supporting trusts to invest in their car parks. We will continue working with NHS England, as well as trusts such as her own, to understand the specific requirements. I understand that an emergency funding application by the Royal Stoke in this respect has been received and is currently being considered. However, I am always happy to discuss with her the specifics of the case she raises.

[Andrew Jones]

Harrogate District Hospital, which is an excellent hospital, will be reducing its carbon footprint by a quarter and making energy cost savings thanks to a £40 million Government grant, but the healthcare estate is much more than hospitals: it is also doctors’ surgeries, specialised units and so on. What steps is my hon. Friend taking to ensure that the whole estate, whether large or small, is included in the decarbonisation investment programme?

[Edward Argar]

How could I have failed to remember to group my hon. Friend’s question? I apologise to him. He is right to pay tribute to his local hospital in Harrogate. Zero carbon and environmental sustainability are key design criteria in our 40 hospitals programme, but it is also right, as he says, for that to flow throughout the NHS estate. The NHS’s net zero report provides a detailed plan for decarbonising the whole NHS estate and services. In that context, there is already a range of action under way, including the £50 million NHS energy efficiency fund, which, as a small example, is upgrading lighting across all NHS buildings, big and small, to improve environmental sustainability.

[Karl MᶜCartney (Lincoln) (Con)]

What steps his Department is taking to support the health and social care workforce during the covid-19 outbreak.

Covid-19

Edward Argar Excerpts

Monday 22nd February 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

I beg to move,

That this House has considered covid-19.

When I last spoke in this Chamber in a general covid debate, on 12 January, we faced a very grave situation. There was a very real risk of our hospitals being overwhelmed, the number of people tragically dying from covid-19 each day was in four figures, and our vaccine roll-out was just getting off the ground. As I stand here today, we have made huge progress, and while there is no room for complacency, thankfully we now face a very different picture.

That we find ourselves in this changed position is largely down to three factors. The first is our amazing NHS and social care workforce. The pressure they have experienced has been phenomenal. Their response to that pressure has been humbling to all of us: the teamwork, the resilience, the dedication. It has been truly inspiring. They have our admiration and our thanks, and we must always reiterate that, but they must also continue to have our unwavering support in the months ahead as we build back better after this pandemic.



The second factor is, of course, our national lockdown. On 12 January, the average number of cases per day was 44,302; more than 30,000 people were in hospital with covid-19; and, on average, more than 1,000 people were dying of the disease each day. Today, we see an average of just over 11,000 cases each day; just under 20,000 people in hospitals with covid; and a heartening and welcome decline in the number of deaths.

[Steve Brine (Winchester) (Con)]

One of the great differences between the start of this nightmare and where we are now is on personal protective equipment for health and care staff, which was a big issue at the start. There were a lot of stories over the weekend about the procurement of PPE. I know from my time as a Minister in the Department that sometimes government is not elegant, but surely what we did was to make sure that we did not run out of PPE. We should congratulate many of the officials in the Department on making sure that that did not happen, as history records it did not. For my constituents who are concerned about the process that went on, will the Minister reassure me that everything was above where it should be?

[Edward Argar]

My hon. Friend was a distinguished Minister in the Department for some time and rightly highlights the situation that we faced at the height of the first wave of the pandemic. It is testament to the phenomenal efforts to procure PPE of the officials in my Department, in the Paymaster General’s Department and others that we did not run out of PPE in this country. Indeed, credit for that should also go to my right hon. Friend the Secretary of State for Health and Social Care, who ensured that throughout he put the provision of PPE and people first, even when, as we have seen, that may have led to challenges and to process not being entirely adhered to in respect of the timings for the publication of contract details. He and I have the greatest respect not only for the recent judgment, which we will consider carefully, but for the importance of transparency. I believe that my right hon. Friend did the right thing: he did everything he could to ensure that his No. 1 priority was to get that PPE procured and to the frontline to protect those who were protecting all of us and helping to save lives.

As on so many occasions over the past year, in recent weeks the British people have once again made huge sacrifices to comply with the necessary restrictions. It has been incredibly hard for individuals and businesses up and down the country, but in the figures that I have set out, we can see the impact that those sacrifices have made in helping to suppress the spread of this virus.

Despite the progress, over the past week an average of 449 people still lost their lives each day—449 families and friends who have lost loved ones. It is still far, far too many. It reminds us that, even now, as we map a brighter course forward, we must never lose sight of the threat posed by this virus.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

When I asked the Prime Minister a question about his road map a short while ago, he said that he supported a public awareness campaigns for people who cannot wear face coverings but are subject to abuse because people are not aware of their exemption. Does the Minister support such a campaign and will he make the same commitment as the Prime Minister, so that people do not face abuse, and so that people are educated and know that there are reasons why people cannot wear face coverings?

[Edward Argar]

The hon. Gentleman makes a typically measured and sensible point. He is absolutely right: those who are exempt from wearing face coverings for medical reasons should be able to go about their lives without fear of abuse or verbal or other attacks on them for not doing so. I heard what the Prime Minister said and I echo those words. The Paymaster General and I will look carefully at what the hon. Gentleman has just suggested in respect of what we can do as a Government to raise awareness of the fact that there are people who, for entirely legitimate reasons, are not wearing face coverings.

Finally, I turn to the third factor that has changed the situation for the better. That, of course, is our vaccine roll-out, which throughout has been key to the future. As of today, we have provided a first dose to over 17.5 million people. That is almost one in three adults in the United Kingdom. Vaccine take-up has surpassed our expectations. In England, for example, we have now given a first dose to 93% of the over-80s, to 96% of those aged between 70 and 79, and to 94% of eligible care home residents. Those are phenomenal achievements—the result of a huge team effort. In that context, I pay tribute to our NHS, to pharmacists, to the armed forces and, of course, to the army of volunteers who have done their bit to help make this process run as smoothly as it has.

Those are vital achievements because we know that vaccines save lives. The cohorts we are currently working to vaccinate by mid-April represent some 99% of covid deaths, but we will not rest until we can offer that protection to everyone. We urge, and I would urge, everyone who has been offered the vaccine to take up that offer, as I will certainly be doing when I become eligible to receive it. It is safe and it is saving lives.

With an average of 358,341 doses being given each and every day in the UK and more vaccines coming on stream in the spring, I believe that we can confidently begin to look to the future. That is why a few moments ago, at this Dispatch Box, the Prime Minister set out his road map for how we will carefully but irreversibly unlock our country. As he set out, it is based on four tests: first, that the vaccine deployment programme continues successfully; secondly, that evidence shows that vaccines are sufficiently effective in reducing hospitalisations and deaths; thirdly, that infection rates do not pose a risk of a surge in hospitalisations that would put unsustainable pressure on the NHS; and fourthly, that our assessment of the risks is not fundamentally changed by new variants of the virus that cause concern.

Our road map out of lockdown will be taken, as my right hon. Friend set out, in four steps, each step reflecting the reality on the ground, not just our understandable expectations and desires. At every stage, our decisions will be led by data, not dates, with at least five weeks between steps; we will review the data every four weeks and give one week’s notice of any changes. The dates that my right hon. Friend set out today are not target dates; they are, importantly, “no earlier than” dates. We will continue to undertake statutory reviews, including the one taking place today. Yet in doing so, we are ever mindful of those expectations and desires.

[Sir Charles Walker (Broxbourne) (Con)]

I am confused. If we are having this driven by data, why are we worrying about timetables and dates? The Minister mentioned “no earlier than” dates, but why? This is data-driven, not date-driven. There seems to be mixed messaging here.

[Edward Argar]

I am grateful to my hon. Friend—indeed, my friend—for that point. The reason we are doing this is that we have been clear throughout, and the Prime Minister has been clear throughout, that this should be the last lockdown we experience and that, once we relax these restrictions, they should be irreversibly relaxed. That is why we are doing it in a staged way, one step at a time, and we will continue to monitor the data, which I hope and believe will continue to go in the right direction. But it is because we do not wish to see anything happen that could cause us to pause or reverse that we are taking it step by step.

[Greg Clark (Tunbridge Wells) (Con)]

But if the data surprise us on the upside, would it be possible to look again at those dates and take advantage of that?

[Edward Argar]

I am grateful to my right hon. Friend. What we have sought to do here is to set out a road map that is measured and cautious but provides, as much as we can, that degree of certainty to allow people to plan for the future. We do not want to set out expectations that are unlikely to be met, and therefore this plan is based on those “at the earliest” dates. If I may, I will make a bit of progress, and then, if we have time—I am conscious of the time—he may wish to return to that point.

We know how tough lockdown has been on people—on individuals, on families and on businesses—and naturally we are beginning—

[Andrea Leadsom (South Northamptonshire) (Con)]

rose—

--- Later in debate ---

[Edward Argar]

If I may just finish this point, then I will of course turn to my right hon. Friend. We are beginning with the things that people want to change most, the most important things being to see children return to classrooms, and to be able to begin to see our friends and family again.

[Andrea Leadsom]

Does my hon. Friend see, as he is hearing from our hon. Friends here in the Chamber, that setting out the very earliest dates assumes there is no harm caused by the continued lockdown but, in reality, if we remain locked down when we do not need to, every single day, that is causing harm to people?

[Edward Argar]

My right hon. Friend makes an important point. Often in this Chamber we look at the impact in terms of hospitalisations, infection rates and deaths from covid, but—absolutely rightly—we also look at the impacts more broadly, and she highlights that it is not just deaths or illnesses directly attributable to covid that have an impact on people’s lives, health and wellbeing. However, I come back to the point that the programme and the dates we have set out are reasonable, pragmatic and supported by what we believe reflects the roll-out of the vaccine to the different groups, and they give the public a degree of predictability that has not been there before. I share what I surmise is her view: I would not wish these restrictions to stay in place a day longer than absolutely necessary—I hope I do not misattribute a view to her there. What the Prime Minister set out earlier today achieves that, and does it in a very measured and sensible way that reduces significantly any risk of our seeing things slide backwards.

I am conscious of time. As the Prime Minister has set out before the House, all schools and colleges will return to face-to-face education on 8 March—

[Chris Green (Bolton West) (Con)]

Will my hon. Friend give way?

[Edward Argar]

Very briefly, but this is the last intervention I will take from colleagues, I am afraid.

[Chris Green]

I thank my hon. Friend for giving way. Will he confirm one way or the other whether secondary school children will be compelled to wear masks in the classroom while they are trying to learn?

[Edward Argar]

I am grateful to my hon. Friend, who highlights a point that, along with others, will be concerning parents and pupils. As we set out the plan for unlocking and reopening our schools, which my right hon Friend the Education Secretary will add more detail to, we will look at how we can create an environment that is not only safe but that allows children and young people to learn, socialise and enjoy the benefits of not just education but being back in school. I know that my right hon. Friend will have listened carefully to my hon. Friend’s point.

As I have just alluded to, we know how important being in school is for children—not only for their education but, as I said, for their social development and mental health. That is why it is a crucial first step, and getting children back into classrooms has unquestionably been the Government’s chief priority.

Within that first step, we also want to begin to meet that other great desire—for families to see those they love. From 8 March, every care home resident will be able to nominate a named visitor, who will be able to visit. From 29 March, up to six people, or two households, will be able to meet outdoors. At that point, outdoor sports will also be permitted, as long as they are in groups of up to six.

In respect of households meeting outdoors, I—I dare say along with many others in this House—look forward to that very much. Aside from a family funeral, 2019 was the last time I saw my parents in person, and I suspect that that goes for many people in this Chamber and, indeed, up and down the country. So we do understand just how important this issue is, and I believe that these first steps recognise that vital desire for human contact and for seeing friends and family. Our ambition is to maintain a healthy lifestyle, while also reflecting our continuing need to save lives, but until 29 March, our message continues to be, “Stay at home and stay local.”

As the Prime Minister set out, the road map sets out a broader package of measures for step two, which will be no earlier than 12 April. The rule of six, or two households, will continue to apply outdoors. Non-essential retail and personal care will be permitted to reopen, and domestic overnight stays in England will be allowed for individual households and bubbles in self-contained accommodation. The majority of outdoor settings will reopen, and hospitality, such as pubs and restaurants, will be allowed to resume table service to customers outdoors. At this point, we will also take a decision on whether we can extend the number of visitors to residents in care homes and set out a plan for the next phase of visits.

Step three, no earlier than 17 May, will take us closer to that normal life we yearn for, with the majority of legal restrictions on meeting others outdoors removed, although gatherings will be capped at 30 people. Six people or two households will be able to meet indoors, and indoor hospitality, entertainment and sports will be allowed. Finally, step four, no earlier than 21 June, will see us take key steps to larger scale events.

The Prime Minister set out in more detail the reviews that would underpin the steps and the support being put in place at this time and the support being continued for those who are affected. Conscious of time, I will not recount everything that my right hon. Friend said at this Dispatch Box just a short hour or two ago.

As we look to brighter days ahead, there are still difficult days immediately in front of us. My right hon. Friend the Chancellor of the Exchequer will be setting out how we will continue to support businesses and individuals through this difficult time and how we can build back better in his Budget statement on 3 March. We will do all we can to ensure that British people remain safe: working to keep uptake of the vaccine high, continuing to ramp up testing, including normalising workplace testing as people return to their workplace in increasing numbers, and ensuring that we take proportionate steps at our borders to protect against new variants from abroad and, indeed, to protect the progress we have made as a country.

It is right, even as we move forward, that we tread carefully through the weeks ahead. I understand and can entirely appreciate the points made by hon. and right hon. Friends from their understandable desire to move faster where we can. The Prime Minister understands that, too. I know him well, and no one more than he will want to see restrictions in place a single day longer than is necessary, but we have learned that this virus can move in unpredictable ways.

We owe it to the NHS and social care staff on the frontline, to everyone involved in our incredible vaccine roll-out and, of course, to everyone in this country who has made such tremendous sacrifices over the past year to hold on to and build on the progress we have made. I believe we can do it by once more working together as a country, unified by a shared determination to see this disease beaten and to see our country return to normal. It has been a long and challenging path we have taken together, but as I stand here today, I do so with confidence in this road map—that route back to the future we all wish to see.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Before I call the shadow Minister, I remind hon. and right hon. Members that there will be a three-minute limit on Back-Bench speeches. When that is in effect, there will be a countdown clock visible on the screens of Members participating virtually and on the screens in the Chamber. For those participating physically, the usual clock in the Chamber will operate.

NHS England and NHS Improvement: Annual Assessment 2019-20

Edward Argar Excerpts

Thursday 28th January 2021 Written Statements

[The Minister for Health (Edward Argar)]

Today, I am laying before Parliament my annual assessment of the NHS commissioning board (known as NHS England) for 2019-20.

Covid-19 has presented an unprecedented challenge, the scale of which the NHS has not seen in its 72-year history. I would like to begin by giving my utmost thanks and appreciation to all colleagues throughout the NHS for their dedication and hard work responding to the virus.

My assessment of NHS England and NHS Improvement’s (NHSE/I) performance for 2019-20 reflects the impact these challenges have had on the health service and differentiates between performance before the pandemic took hold and the subsequent impact managing the virus has had on delivery. To this end, I have defined performance pre-covid-19 as the period April 2019 to end January 2020. Evidence from this period has been used to make a reasonable assessment of where performance would have been had covid-19 not happened.

2019-20 was a transitional year for the NHS, that saw NHSE/I embed the first phase of delivery against the NHS long term plan. NHSE/I has worked closely with local health systems to develop robust, system and local-level implementation plans. In 2020-21 these plans will need to be revised to reflect possible new and longer-term demands caused by covid-19 and to account for the Government’s 2019 manifesto commitments. To ensure these plans are workable NHSE/I must ensure disciplined financial management across all organisations. I am therefore pleased to see most NHS providers reporting a year-end position that is equal to or better than their agreed control totals.

To ensure performance targets are appropriate and help improve clinical quality and outcomes, NHSE/I has field tested proposals in urgent and emergency care, routine elective care, cancer and adult and children’s mental health as part of the clinically led review of NHS access standards. The impact of covid-19 has delayed the final evaluation report and I expect NHSE/I to continue to work with wider Government and local NHS organisations to produce evidence-based approaches. An increase in demand for services in 2019-20 pre-pandemic has meant that performance targets on NHS constitutional standards were not on track to be met by the end of the year. Between April 2019 and January 2020, demand for urgent investigation of possible cancer and emergency admissions via A&E increased by 8% and 3.5% respectively, compared to the same period last year, making it harder for the NHS to treat patients within the agreed targets. Key to managing demand in the system is ensuring a steady flow of patients through to the point at which they can be safely discharged. Despite great efforts in both health and social care, the average delayed transfer of care (DTOC) figure of 4,000 or fewer delays remains challenging and the trajectory up until January 2020 was 5128 leaving a cumulative target of 1,182 beds to be delivered.

Another key element of the NHS long term plan was publication in June 2019 of NHSE/I’s interim people plan that was reinforced in August 2020 with the “We are the NHS: People Plan for 2020-21—action for us all”. The publication of the overarching NHS people plan will need to account for new workforce demands and costs due to the pandemic as shortages remain a critical risk to service recovery. It is also critically important that we have rigorous plans in place to deliver the additional 50,000 nurse places that the Government promised to deliver in this Parliament. I am also grateful that NHSE/I has taken the lead in supporting members of our workforce who are most vulnerable and provided an enhanced staff health and wellbeing offer, including targeted support for our BAME colleagues and, where possible, offering opportunities for flexible and remote working.

I am pleased to see NHSE/I support the Government’s health and social care pledges set out in the 2019 manifesto. Great progress has been made on capital in 2019-20, which was underpinned by the health infrastructure plan (HIP), published in September 2019. The Government are committed to building 40 new hospitals, and the NHS has already made significant progress in developing these plans to deliver world-class care in world-class facilities. Similarly, the NHS has pressed ahead with delivering the 20 hospital upgrades announced by the Prime Minister in August 2019. I am assured NHSE/I has committed to work with the Government to improve public confidence in hospital food and commend them for supporting the commitment to abolish hospital parking fees for those patients and families in greatest need.

Looking forward, I am pleased to see NHSE/I use evidence from responding to covid-19 to reduce barriers and improve the way services are delivered. The pandemic has also brought to light the burden placed on the NHS by the interoperability of systems and the need for more effective information sharing between care settings and organisations, as well as between professionals and the public, to enhance health outcomes and quality of care. I am therefore eager to see the implementation of the technology standards set out in the “Future of Healthcare” to better integrate information flows.

The NHS remains this country’s most valued public service, an institution that is there for every family, everywhere, at the best of times and at the worst. In light of covid-19, the Government want to continue to ensure that the NHS has the space, certainty and funds to deliver a transformative plan that will ensure patients benefit from a ground-breaking health service into the next decade.

We will continue to work closely with NHSE/I to help them deliver this ambition, address the challenges that lie ahead and provide a sustainable and efficient health service with quality, transparency and safety at its heart.

Copies of my annual assessment and NHSE/I’s annual report will be available from the Vote Office and Printed Paper Office.

[HCWS741]

Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 4) Regulations 2020

Edward Argar Excerpts

Monday 25th January 2021 General Committees

[The Minister for Health (Edward Argar)]

I beg to move,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 4) Regulations 2020 (S.I. 2020, No. 1654).

It is a pleasure, Mr Pritchard, to serve under your chairmanship on one of these Committees—for, I think, the first time. At the outset, I pay tribute once again— as the shadow Minister does each time we have these debates—to the work of our health and social care staff and key workers in this country, who continue, day in, day out, to keep people safe, and to keep this country working. They are clearly, for these reasons, the pride of our nation. I also put on the record my thanks to the population of this country for continuing to follow the lockdown rules. We all know that is incredibly difficult and entails huge sacrifice, but the actions everyone is taking are protecting our NHS, buying time for the roll-out of the vaccine, and saving lives.

While our focus remains on vaccine roll-out and the necessary national lockdown, to keep down infection and hospitalisation levels, it is nonetheless important that we bring forward these regulations, even though they make by and large only minor technical amendments to the “All Tiers” regulations, necessary for legal coherence. Those regulations give effect to the 29 December tiering decisions, which of course have been superseded by the national lockdown restrictions, but it is still right that they be debated in this place. To briefly run through the effects of this statutory instrument, it amends regulation 8(4)(b) of the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020, substituting

“the Tier 2 area and the Tier 3 area”

with

“the Tier 2 area, the Tier 3 area and the Tier 4 area”,

to ensure that the addition of tier 4 is captured. That essentially makes it clear that tier 1 covers every area of England other than those areas in tiers 2, 3 and 4, and therefore that tier 4 restrictions apply only in a tier 4 area. That, of course, is now the whole of England, following the Prime Minister’s announcement of a national lockdown on 4 January. This might seem like nit-picking or a minor clarification, but we feel it is important to remove any scope for misinterpretation from the instrument.

The instrument also makes a further technical amendment to the “All Tiers” regulations, correcting a cross-reference in paragraph 8 of schedule 3A to the “All Tiers” regulations. The larger change in this instrument is the amendment of schedule 4 to the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020 to move some local authority areas from tiers 2 and 3 to tiers 3 and 4, although those changes have been superseded by the national move to tier 4.

Given the rapid rise in covid cases in several areas at the time these decisions were made, and the likely progression of the new variant, it was agreed on 29 December 2020 to move these local authority areas between the tiers. Decisions on which tier would apply to each area were initially announced on 2 December, and were based on five key indicators: case detection rates in all age groups; case detection rates in the over-60s; the rate at which cases were rising or falling; the positivity rates—the number of positive cases detected as a percentage of tests taken—and, of course, pressure on the NHS in a particular area, including current and projected occupancy.

Before concluding, I put on the record our regret that the regulations could not be debated until now; obviously, the House did not sit until 11 January. Two weeks after the House came back, we have brought them forward. That is swift, but still, I apologise to the House and to my shadow, the hon. Member for Ellesmere Port and Neston, for the fact that we did not have the opportunity to bring them forward for debate in a more timely fashion. None the less, we feel it is important—indeed, it is required—that we bring them forward at this point for the House to scrutinise and challenge them if it wishes.

Furthermore, we may decide to step areas down through the tiers when it is possible to revert to that approach. Therefore, for consistency in the law and confidence in the tiering system, it is right that these technical amendments and tier allocations be considered.

We should remain cautious about the timetable ahead. If our understanding of the virus does not change dramatically, roll-out of the vaccine continues to be successful, deaths start to fall as the vaccine takes effect, the covid situation in our hospitals improves and everyone plays their part by following the rules, we hope—at the right time, when it is safe to do so—to be able to move out of the national restrictions.

I finish by paying tribute once again to our amazing health and social care staff, who are working tirelessly throughout this pandemic. As always, I remind everyone of the importance of following the rules, which are in place for very good reason, and I commend the regulations to the Committee.

--- Later in debate ---

[Edward Argar]

I will endeavour to address the various points raised by the shadow Minister, the hon. Member for Ellesmere Port and Neston. It is a pleasure to serve opposite him in these Committees. He is always measured in his remarks and constructive in the points that he makes. Even when disagree on interpretation, I always welcome his observations and his reasoned challenges.

When the hon. Gentleman mentioned the work that his wife is doing as a local councillor, he kindly did not mention that when paying tribute to our health, social care and key workers, I missed our local authorities. I pay tribute to the officers of those local authorities and to local councillors, who always work very hard but who will be facing an incredibly heavy workload at the moment, serving their communities. In that vein, I pay tribute to them, including the hon. Gentleman’s wife for her work.

The hon. Gentleman is right to highlight the scale of the challenge and the situation that we face, and the number of tragic deaths we have seen. As he rightly said, every one of those is an individual with family and friends, and every one of those deaths is a tragedy. He highlighted that there are 38,000 covid patients hospitalised at the moment, which is well over a third of the beds in our NHS. To demonstrate how rapidly that number has climbed, back in September there were 500 people hospitalised with covid; in October, the number went up to about 2,000; by November, it was 11,000; and, in the past month and a half, we have seen it go up to the current level. The rate of hospitalisation has increased dramatically and he is right to highlight that backdrop to our debate.

The hon. Gentleman mentioned retrospectivity, not in the implementation of the regulations, but in debating them after the for. While that may be in line with what is permitted under parliamentary procedure with statutory instruments of this sort, I take his point that it is better to debate them in a timely fashion, That is what we seek to do, because the House can give its view on them and because the transparent process helps to achieve consent to, and therefore compliance with, the measures. I hope the hon. Gentleman will acknowledge that we have made some significant strides since—well, not since this time last year, but since last spring, now that the House has found a way of speeding up the pace at which we bring statutory instruments before Committees.

The hon. Gentleman asked a specific question about statutory instruments being made on 30 December, a day when the House was sitting. The short answer to his question why they could not be debated that day is because they were only signed and made by the Secretary of State on that day, while the House was sitting, so there was no time to lay them or schedule them for debate. That is why we have brought them forward now, although of course events have slightly superseded them.

On tiering and the effect of tiering, which was the subject of a large part of the hon. Gentleman’s remarks, I have to be very honest. Throughout this pandemic, we have said, “Here is what we are working to achieve, but even now this disease is something that we are still learning more about every day.” The perfectly reasonable and scientifically rational tiering restrictions and regulations in December having to be superseded this month is in large part due to the new variant, with its significantly higher infectiousness. It was not present when the original tiering regulations were put in place. There will always be an element of having to adapt to this disease as the disease itself adapts.

The hon. Gentleman asked what determines whether an area is in a particular tier and how it can move between tiers, and he quite rightly picked up on the five tests, or the five measures, that the Secretary of State has set out. Sadly, he was right to predict that I would say the process is not black and white and is more complex than that. That is because it is the inter-relationship between the factors that matters. For example, the infection rate overall could appear to be plateauing and then coming down, as was the case for a period in my own constituency, while the rate in the over-60s continues to grow. That is a great concern because of the impact of this disease on that age group, and on older people in general,. I fear that it will not be possible to say, “Here is an exact figure for each of these, and if you hit these figures, that moves you from x to y.” A more nuanced and more complex judgment is required

The hon. Gentleman spoke about the importance of data and in particular dashboard data at a localised level, so that people can at least understand the data that is driving these decisions. I hosted a call with colleagues back in December, when we had some of our team in DHSC talk through how we were developing that data dashboard, looking at the data and then subsequently providing ever greater granularity. That work continues and he is absolutely right to highlight it. I suspect that there will always be an appetite for data that we are continuing to chase and trying to keep up with, but we continue to try to put more and more data out. I would argue that, as a country, we have been at the forefront of data transparency and putting information out there. There is always more that we can do, but compared with other countries, on testing rates for example, we were at the forefront of putting data out there, even when that was quite rightly being challenged or questioned by him and by others.

We publish the SAGE papers, but I think what the hon. Gentleman was asking me to pass on to the Secretary of State was a request that those papers are not only published, but published in tandem with recommendations and decisions. I will certainly convey his points to the Secretary of State, as I will to the Transport Secretary. The hon. Gentleman is quite right that those points are above my pay grade in this role, as they relate to borders and travel.

There are three other things that I will touch on very briefly, which I think will cover what the hon. Gentleman asked about: vaccine roll-out, compliance, which he touched on, and bigger-picture elements about when we are likely to see an easing, for want of a better way of putting it, which is the road map argument, including schools as a pathway. I will try to address some of those issues, albeit briefly.

On the vaccine, the hon. Gentleman is absolutely right: we believe, and it has always been part of our strategy, that the vaccine is our way out of this pandemic. It must be delivered quickly and safely, as he said, and I believe that it is being delivered very swiftly and safely across the country, not just by our NHS and our military, but by volunteers who are helping to run the vaccination centres. The huge number of vaccinations that have already taken place is testament to the planning and the work that has been done. As the Secretary of State has always made clear, although we are getting a huge number of people vaccinated, supply is potentially a limiting factor. We will vaccinate as many people as we can get the vaccines for, but there will always be a potential limiting factor there.

On compliance, the hon. Gentleman raised a number of points. The population of this country has been phenomenal in its willingness to comply with incredibly onerous and challenging restrictions. He highlighted support from the Department for Work and Pensions and elsewhere for particular groups, including statutory sick pay and other isolation payments. The Government continue to keep compliance rates and the factors that influence them under review.

The hon. Gentleman’s final question, which is a subject of considerable discussion at the moment, was about the road map for the easing of the national lockdown and how it interacts with the vaccine roll-out. I am afraid that I have to disappoint him slightly. To echo what the Prime Minister said, we all know what we would like to see, and the number of people vaccinated, particularly those in the vulnerable groups, is a key element not just of keeping people safe and being able to ease restrictions, but of decreasing the pressure on the NHS. However, we also know that there is a long lag time between people being infected and then going into hospital and being kept there. Thankfully, with new drugs, we are able to save the lives of people who might have died in the first wave, but they are in hospital longer, so the pressure on NHS capacity will continue for some time.

It would be wrong to set an arbitrary road map and timetable when, as I say, we are constantly learning more about how this disease behaves and moves in the population. We can set out our ambitions in broad terms, but it would not be right to say, “If we hit x number, that equals x date, which equals x change.” It would be premature to do that. It is right that we are open and transparent with the British people, but we are not at that point yet.

[Justin Madders]

I pay tribute to all those involved in the vaccine roll-out. I had the pleasure of visiting my local centre a couple of weeks ago, and it was very well organised. I was trying to gain some understanding from the Minister about whether the vaccine roll-out will be applied to tier decisions, or whether the national picture will be part of the decision. I do not expect him to say, “This number of people receiving a dose is going to mean x, y or z relaxations,” but will that be considered at national or local level?

[Edward Argar]

I am grateful to the shadow Minister for his clarification. If I am being honest, I think it is probably premature at this point for us to speculate about things at that level of detail, but he makes his point well and it is on the record. I will relay it to the Secretary of State as we look at when the time is right for us to start easing the national regulations and potentially move towards a tiering model again. At that point, those sorts of question are of course pertinent, and I will ensure that the Secretary of State is aware of the hon. Gentleman’s comments.

The hon. Gentleman’s final point was, in the context of vaccines, infection rates and hospital pressure, about the need for information to be as local and granular as we can get it. Vaccinations started in earnest in early to mid-December, and we have ramped up at a huge rate the number of people being vaccinated each day. In parallel with that, we have continued to try to increase the amount and granularity of information that we publish on gov.uk and on the dashboard about vaccinations by region, area and volume. In parallel with actually getting the vaccine in people’s arms, the team continues to look at what more they can do to be as transparent as possible about how that is going, so that people in a local area can understand a bit more about what it means for them.

I hope I have addressed if not all then as many as I can recall of the hon. Gentleman’s questions and points. I commend the regulations to the Committee.

Question put and agreed to.

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 4) Regulations 2020 (S.I. 2020, No. 1654).

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 12th January 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

Covid, and particularly the new strain of covid, has had a significant impact on NHS bed capacity. As of 10 January, 30,758 beds across the NHS were occupied by covid patients. In just the past day, that has risen to around 32,000, which is over a third of all available beds. The latest bed occupancy data shows that just shy of 80,000 of the NHS’s roughly 90,000 total general and acute beds were occupied.

[Dr Huq [V]]

It is great that the NHS, as I have heard locally, is working hard to stop intensive care beds from running out after a decade of no expansion, now that a major incident has been declared in London. However, can the Minister guarantee that this will not just be a bureaucratic exercise? Will we take a population-based approach, listen to clinicians in apportioning capacity and allow hospitals in high-need mixed ethnicity areas, such as Ealing Hospital, which is currently on a black alert, their fair share, rather than the powerful players—the central London teaching hospitals—always getting all the extra allocation?

[Edward Argar]

I can reassure the hon. Lady that beds and increased capacity, where we put them in place, are allocated on the basis of where they are needed. She is right to highlight the pressure that her local hospital trust, London North West University Healthcare NHS Trust, is under. The team there, as across the NHS, are doing an amazing job, but the critical care bed occupancy rate in her trust was 98.7% on the latest figures I have. That is extremely significant pressure, but I can give her the reassurance that we look to ensure that all areas receive the resources they need.

[Ellie Reeves [V]]

London has declared a state of emergency and the stark reality is that at this rate we will run out of beds for patients in the next couple of weeks. At least two NHS hospitals in the capital have already postponed urgent cancer surgery and figures show that treatment levels are failing to keep pace with demand. Will the Minister therefore commit to fully opening the London Nightingale hospital, secure the use of London’s private hospitals for cancer treatment, and invest in the number of beds in our NHS for the long term?

[Edward Argar]

The hon. Lady is absolutely right to highlight the pressure that the NHS and critical care are under in London and, indeed, more broadly. I pay tribute again to all those who are working in the NHS, including my shadow, who I suspect has been on the frontline in recent days—I pay tribute to her, too. The best way we can thank them is by following the advice to stay at home and to follow the rules. In respect of her specific point, yes, we are involving independent sector capacity, Nightingale capacity and increasing NHS capacity—all those, alongside other measures—to ensure our NHS continues to be able to treat those who need this care at this time.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Last night, I finished a shift in a busy east London hospital, sharing difficult news with hopeful families. The resilience of staff on the frontline can never be matched, but across the country morale is on a cliff edge. A decade of cuts to beds, services and staff, combined with pay freezes, has left NHS workers undermined and undervalued. Without our incredible staff, a hospital bed is just that —a bed. So does the Health Minister regret how the Government have made frontline workers feel and can he promise to change that?

[Edward Argar]

I reiterate, as I did earlier, my thanks to the hon. Lady and all her colleagues in the NHS for everything they are doing. I reassure her, as I do and as my right hon. Friend the Secretary of State does at every opportunity, just how valued and supported our NHS is. We have put in place just over 1,000 additional critical care bed capacity at this time—the right thing to do. In addition, in respect of supporting staff, we are investing about £15 million—just one example—for mental health hubs and mental health support for staff. I saw, from the hospital that she works in, or has worked in, in her constituency, a number of staff—it was on the BBC recently—setting out just how flat out they are. The best way we can thank them, alongside what we are doing—I make no apologies for reiterating it, Mr Speaker—is by all following the rules to stay at home to help to ease the pressure on those phenomenally hard-working and valued staff in our NHS hospitals.

[Rachael Maskell (York Central) (Lab/Co-op)]

If he will make a statement on his departmental responsibilities.

Covid-19

Edward Argar Excerpts

Tuesday 12th January 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

I beg to move,

That this House has considered covid-19.

Thank you, Madam Deputy Speaker, for your courtesy in slightly drawing out your introduction to allow me to take my mask off as I came to the Dispatch Box.

It is less than a year since the coronavirus was first mentioned in a debate in this House, on 22 January 2020. The House has debated this issue, which has affected all aspects of our national life, on many occasions since then. I would say at the outset that, throughout, it is important that we remember that all Members of this House share a common goal. They may have differences of opinion and there may be different perspectives on how best to achieve that goal, but it is important that we are clear that every Member of this House is clear in their determination to see this virus beaten and to see our country recover economically and in every other sense. I pay tribute to all right hon. and hon. Members and to the strength and sincerity of their views on this important topic. Since that first debate, novel SARS-CoV-2, which of course we all now know too well as covid-19, has caused untold disruption to all our lives and our way of life in this country. It is right, at this point, that we remember all those who, sadly, have lost their lives to the disease.

In this first general debate on covid-19 of 2021, it is worth reflecting that despite our painful familiarity with the challenges we face, the situation today is markedly different from many occasions in the past. For a start, and perhaps most importantly, we now see the way out. We have not one but two safe and effective vaccines being injected into people’s arms up and down the country as we speak.

[Sir Charles Walker (Broxbourne) (Con)]

Sorry, Madam Deputy Speaker, just let me take my mask off.

I thank my hon. Friend for his introductory remarks. The vaccine is being rolled out across the country, and in Broxbourne, but a number of my constituents are waiting to be informed by post, as I understand will be the case across the country. There are difficulties with the post at the moment, through nobody’s fault but the virus’s, so could he keep an eye on the postal service to ensure that, if post is not the best way, another way can be found to let people know that their number is coming up in the draw for the vaccine?

[Edward Argar]

It is always a pleasure to hear from my hon. Friend, who is also my friend, in this House, and he raises an extremely important point. I can give him the reassurance that I, other Ministers and particularly the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), who is leading the vaccine deployment effort, will continue to look at ensuring that every means appropriate is utilised to ensure that people in my hon. Friend’s constituency and across the country get notified when their turn is up, so that they have every opportunity to get that life-saving injection.

[Catherine West (Hornsey and Wood Green) (Lab)]

rose—

--- Later in debate ---

[Bob Stewart (Beckenham) (Con)]

rose—

[Edward Argar]

I will give way briefly to the hon. Lady, and then to my hon. and gallant Friend.

[Catherine West]

Does the Minister agree with the suggestion that, given that youth unemployment is shooting up, this might be the time for Royal Mail to take on some extra staff to cover those who are off sick? It is crucial that people know when their appointments are so that they do not miss that golden opportunity to get the jab.

[Edward Argar]

I had the pleasure of working with the hon. Lady in a past life before either of us were Members of this House, and she makes a typically sensible suggestion, which I am sure Royal Mail will have heard. I hope that it will reflect carefully on what she has said.

[Bob Stewart]

The real problem is that people will not know whether they have been called, because the post has not arrived. In my constituency, several instances have come to my notice of people not getting post for over a week. If they are called forward in that week, they are stymied, aren’t they?

[Edward Argar]

I reassure my hon. and gallant Friend that, while there may on occasions be challenges with the post, we are persistent in our determination, and the NHS is persistent in its determination, to ensure that everyone has the opportunity to get this jab. Where someone does not respond, or does not turn up for an appointment, we will keep trying, because it is really important that everyone has the opportunity to have that injection, which could save their life.

[Andrew Griffith (Arundel and South Downs) (Con)]

rose—

[Edward Argar]

I will give way to my hon. Friend, but then I will make some progress.

[Andrew Griffith]

I thank my hon. Friend for giving way; I know he will want to make progress. One group is further away from receiving a vaccine: undergraduates who would otherwise be returning to college today. A significant proportion of their education has been disrupted already. Is there any hope that the Minister can offer to the nation’s undergraduates?

[Edward Argar]

I am grateful to my hon. Friend. I seem to be taking multiple interventions today from people I have known in a past life in different ways and forms, which is always a pleasure. He will be aware that the prioritisation and roll-out of vaccines in that context are guided by the clinical advice of the Joint Committee on Vaccination and Immunisation, which, as he will appreciate, at the current time, and rightly, is clearly focused on what will do the most to save lives. We have seen—I will turn to this in my speech shortly—that age is the single biggest determinant of risk of death, so it is right that we are prioritising those most at risk as we roll out the vaccine. When I come to them later, he will hear about the very ambitious and deliverable plans, which he heard about from the vaccines Minister yesterday, to ramp up the roll-out across our country.

[James Sunderland (Bracknell) (Con)]

rose—

--- Later in debate ---

[Edward Argar]

I did promise my hon. Friend that I would take an intervention from him—then I will make progress.

[James Sunderland]

In 1940, when our small boats set sail for Dunkirk, nobody stopped to check through health and safety paperwork or institutional red tape. Will my hon. Friend the Minister please confirm that the Government will cut through unnecessary bureaucracy as we embark on the vaccine roll-out, and that we will throw the kitchen sink at this with the help of our armed forces?

[Edward Argar]

I am incredibly grateful to my—if I recollect correctly—hon. and gallant Friend, who has served in the past with distinction. He is absolutely right to highlight the amazing work of our armed forces, which was highlighted in the Chamber earlier this afternoon. He is also right to highlight the spirit of getting things done. He will have seen that my right hon. Friend the Secretary of State for Health and Social Care has been very clear that, while making no compromises on safety for patients and for those receiving the vaccine, he is working very hard to make sure that any bureaucratic barriers that do not support patient safety are removed to ensure the speedy and effective roll-out of the vaccine. So I am grateful to my hon. Friend for his point.

We have vaccinated more people than the rest of Europe put together—well over 2 million individuals, including more than a quarter of the over-80s in this country. I think that is a record to be proud of, but there is no room for complacency. We continue to work hard to get more injections in more people’s arms.

In that context, I pay tribute not just to the Secretary of State and to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Stratford-on-Avon, but to Kate Bingham and the Vaccine Taskforce, who have done so much to make sure that this country was at the forefront of being able to purchase and deploy vaccines to help save lives. Yet, just as we accelerate the deployment of the vaccine further and faster, we must also recognise that the new variant of the coronavirus does present us with a renewed challenge.

Our strategy has always been, and continues to be, to suppress the virus to protect the NHS and save lives until a vaccine can make us safe, but with a new variant that is more than twice as transmissible, we must be clear that that task becomes considerably harder. The figures from the Office for National Statistics are stark: more than one in 50 of the UK population has the virus and an even higher proportion than that in places such as London. So, just as the virus has evolved, so must our response. We find ourselves once again in a difficult and challenging national lockdown, taking steps that I do not think anyone could have imagined in January last year—steps that, understandably, are truly testing the patience and forbearance of every person in this country but that are essential to relieve the pressure on our NHS, allow for the vaccine to be effectively deployed and, ultimately, set us free from the need for these restrictions.

Before I turn to those steps in a little more detail and the deployment of our vaccines, I am sure the whole House will, as always, join me in paying tribute to the heroic responses we continue to see from people in every walk of life. The return of the clap for carers initiative last Thursday, under the new guise of clap for heroes, is a reflection of the shift in our collective understanding of just what heroism and service look like and a tribute to everyone who is helping us push through this difficult time.

I know that my constituency neighbour, the hon. Member for Leicester West (Liz Kendall), will join me in paying tribute to and thanking everyone who works in our NHS in this country and all those who support not just the NHS but social care, in care homes, social care settings and domiciliary care—people in a range of roles up and down our country who, day in, day out, selflessly care for those who need it. In a past life, I was a local councillor, and I had the privilege of being the cabinet member for adult social care, health and public health for the council on which I served. I saw at first hand the amazing work that our social care workforce do, and it is right that we recognise that at every opportunity in this Chamber.

It is also important to highlight the great British scientists who are at the forefront of humanity’s fight against this virus, developing not only the Oxford-AstraZeneca vaccine but life-saving treatments for those who become infected with covid, first in the form of dexamethasone and now tocilizumab and sarilumab—I have considerable sympathy with the Prime Minister in his attempts to pronounce those—both of which have been found to reduce the risk of death for critically ill patients by almost a quarter and cut time spent in intensive care by as much as 10 days. Those life-saving drugs are now available through the NHS, and it is an example of the huge debt of gratitude we owe people from all walks of life—not just those on the health and social care frontline, but people who are working under very different but no less considerable pressures for our country. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who is the Minister for prevention, public health and primary care, will no doubt reflect on that when she winds up the debate.

In terms of the context, I must first turn to the pressures in our acute hospital settings. Across the UK, there are more than 32,000 patients in our hospitals with covid. That is over a third of the NHS’s available beds of all types. On 31 December last year, the total reported admission to hospital and diagnosis of covid in English hospitals was 2,536—on one day. That increased by 46% in the week that followed, so on 9 January, we were seeing 3,718 people admitted. The pressures on our acute hospitals and those who work in them are intense. Patients are therefore currently being treated in Nightingale hospitals in Manchester, Exeter, Bristol and Harrogate to cope with these numbers, and NHS England has confirmed that the Nightingale in London is also open for patients.

Last Monday, all four UK chief medical officers recommended that we move the country to covid-19 alert level 5, meaning that in their expert view, there is a material risk of healthcare services being overwhelmed. In this place, we have often talked about the most frightening of possibilities, but frankly, we have never been this close to seeing it happen, although we are all doing everything we can to ensure that the NHS continues to be able to cope during this time. Quite rightly, we have thanked our NHS staff, and people in this country have expressed gratitude and clapped them, but I think it is fair to say—echoing some of the intensive care doctors and nurses I have seen in the media recently—that the best way we can all say thank you to our NHS is to follow the rules and stay home in line with those rules, to ease the pressure on them.

That is why the choice that this House took last Wednesday to vote overwhelmingly for new regulations, placing England into a national lockdown alongside the action taken in each of the devolved nations, was the right choice. The key message is and must be as it was in the spring, as I have just enunciated: you must stay home. We have always said, and I have always been clear, that it is right that schools should be the last thing to close, and we deeply regret that we have had to close them, but as we begin to move out of lockdown, when we can safely do so—and, as the Prime Minister has promised, through the gradual loosening of restrictions when we can—schools will be the first thing to reopen.

Our regulations provide for these new restrictions until 31 March 2021. I hope that they may not be needed for as long as that, but that time allows us to take steady, controlled and evidence-led decisions, including moving places down through tiers on a local basis—again, when it is safe to do so. As you would expect, Mr Deputy Speaker, we will of course keep these restrictions under continuous review, with a statutory requirement to look at them every two weeks and a legal obligation to remove them if they are deemed no longer necessary to limit transmission of the virus.

[Sir Edward Leigh (Gainsborough) (Con)]

On that point, to me, the right strategy to stop the NHS being overwhelmed seems to be to have a flexible tier system, whereby we work out whether local hospitals in each region are about to be overwhelmed; and, if they are, we go into lockdown. Does my hon. Friend understand what I am saying? Is there going to be this flexible approach, rather than this mass lockdown nationally?

[Edward Argar]

I am grateful to my right hon. Friend for his intervention. With the new variant identified before Christmas, we are seeing hospital admission rates and demand for hospital services rising across our country. That is why it was absolutely right that we instituted the measures that we did, which have seen what it is effectively called a national lockdown at this time. The Prime Minister and the Secretary of State for Health have been clear that they hope, and would expect, that as we get the infection under control and ease the pressure on the NHS, when it is safe to do so we will be able to look to returning to that tiering system. Exactly as my right hon. Friend says, one of the five key factors in whether an area went up or down among the tiers was local hospital capacity—and I emphasise the “local” in that context—but, sadly, we are not in that place as we stand here and debate this matter today.

[Mr William Wragg (Hazel Grove) (Con)]

My hon. Friend is being very generous with his time. Could he perhaps say more about what percentage of those vaccinated in the vulnerable categories will count towards such a consideration?

[Edward Argar]

If my hon. Friend will show a little forbearance as I make a little progress, I will come to vaccinations and the vulnerable in a moment. I will seek to address his point then; if I do not, I am sure that he will prompt me.

I think every Member of this House fully appreciates and understands the huge burden that these restrictions now place on people today and every day: on pupils, on parents, on businesses, on individuals and on families. The Secretary of State for Education has set out our plan to support people in education settings, including with the provision of new equipment for remote learning. For businesses such as those in retail, hospitality and leisure that have been forced to close their doors once again, we are providing an additional £4.6 billion of support. There will be not a single Member in this House who has not received correspondence and pleas from their constituents who run businesses, be it in hospitality or the self-employed—a whole range of people. Members on both sides of the House will be working flat out to seek to assist them. I do appreciate the pressures that they are under. Of course, that support comes on top of our unprecedented £280 billion plan for jobs, including the extension of the furlough scheme until April.

Let me turn to vaccines. We know that in the long run the best way to help everyone in this country is to suppress the virus and to vaccinate people against it. The NHS is committed to offering, by 15 February, a vaccination to everyone in the top four priority groups, who currently account for more than four out of every five—roughly 88%—covid fatalities. The groups include older care home residents and staff, everyone over 70, all frontline NHS and care staff, and all those who are clinically extremely vulnerable. In working towards that target, there are already more than 1,000 vaccination centres throughout the country, including more than 200 hospital sites, which will increase to 270, and some 775 GP-led sites. Of course, pharmacies are already working with GPs to deliver the vaccine in many areas of the country. As vaccine supply increases, community pharmacies will continue to play an essential role.

Before my hon. Friend the Member for Hazel Grove (Mr Wragg) prompts me, let me turn briefly to the question he asked. The Prime Minister and ministerial colleagues will take into consideration a number of factors when looking at the right time—the safe time, based on the scientific and clinical advice—to ease the current restrictions and to move to a tiered system. One factor that I know will weigh with them and play a part in that decision will be the extent to which vaccination has significantly reduced the risk of death in those groups most likely to be affected by the virus. It would, though, be premature—indeed, it would go well beyond my pay grade—for me to set out the detail of what precise considerations the Prime Minister will be looking at as we reach that point, hopefully in a few months’ time.

This week has seen the announcement of the opening of seven mass vaccination hubs in places such as sports stadiums and exhibition centres, and yesterday we launched our full vaccine deployment plan, which includes measures that we will take, together with local authorities, to maximise take-up among harder-to-reach communities, and our new national booking service, which will make it easier to book and access appointments. In that context, I should pay tribute to one of the great strengths of this country, which is the willingness of the people of this country to step up, pull together and volunteer to assist in times of great need for this country. We are seeing that happening now. In that context, I also pay tribute to The Sun’s “Jabs Army” campaign, through which The Sun is doing its bit to encourage people to sign up and to volunteer—I believe it has got more than 30,000 people to sign up. All this is a reflection of the innate strength of community in this country: when something needs to be done, the people of this country step up and do their bit.

Another part of the plan is our new vaccinations dashboard, which gives daily updates on our progress in the biggest vaccination effort in British history.

[Mark Tami (Alyn and Deeside) (Lab)]

The Minister has not touched on the covid deniers out there. No doubt we are all getting emails from them, and they are obviously on social media as well. It is important that we get across the message about the safety of the vaccine and the importance of everybody getting a vaccine. It is not just about someone’s personal freedom and what they do; it is about what they can give to somebody else as well.

[Edward Argar]

The right hon. Gentleman is absolutely right. I say to those who may doubt or speculate about this disease: it is real and it has, sadly, taken more than 80,000 of our fellow citizens from us. Watch the news coverage that we all see every night of our amazing frontline NHS staff explaining just what they have seen, what they have had to do on their shift, how they have fought valiantly to save people’s lives, often successfully but on occasions sadly not, and what that has meant for them. I reflect on an incredibly dignified elderly gentlemen whom I saw on the news before Christmas—I think his name was Mr Lewis from the Rhondda—who, in the space of a week, had lost his wife and two other members of his family to this cruel disease. I say to those who say that it is not serious and that it is not as dangerous as some people say: watch those news clips and listen to those people who have been bereaved, and to all those people who have been in hospital and thankfully have recovered but have been through hell and back with this disease. The right hon. Gentleman is absolutely right. We all have a part to play in following the rules and beating this disease. I, for one, as soon as I am eligible to have my vaccination—I fear that the grey hair may not get me higher up the list and that I am too young, along with my shadow, and we may have a while to wait—will certainly take up that offer.

[Sir Charles Walker]

The Minister is being so generous in giving way. Long covid will take another form: there will be mental health consequences. May I make one suggestion? We have the two eminent professors flanking the Prime Minister, Professors Whitty and Vallance. At some stage, could we have someone of equal eminence from the mental health field to talk about how we are going to do the mental health piece of the recovery?

[Edward Argar]

My hon. Friend makes a hugely important point. He, of course, has been a huge champion in this House for the cause of mental health. I know that, as we speak, the Minister for Patient Safety, Suicide Prevention and Mental Health, my hon. Friend the hon. Member for Mid Bedfordshire (Ms Dorries), is involved in discussions and meetings about exactly that. There is already support in place, but she is very clear that we need to recognise, in the context of long covid and the impact of this disease, including its indirect impacts, that the future mental health of our nation is hugely important, so my hon. Friend is right to highlight it.

At this Dispatch Box, we have often had occasion to exchange grim statistics: cases, hospitalisations and, sadly, deaths. Of course, behind every one of those numbers is a person—a person with hopes, fears, dreams, families and friends—but I know that the whole House will join me in looking forward to exchanges about perhaps more positive statistics in the weeks to come, of more vaccines given, more people safe and more lives saved.

Before too long I hope we will find ourselves in a situation where we can look at the curve of a graph going up and up not with fear and trepidation about what it means but with tremendous hope, as we look at a graph of vaccines delivered. That prospect is within our grasp, and although we are not yet out of the woods and must not blow it now but must stick to the rules for a little longer until we can be safe, I believe that that prospect should cheer us through the difficult weeks ahead.

[Mr Deputy Speaker (Mr Nigel Evans)]

I pay tribute to the volunteers in Clitheroe whom I saw on Friday helping GPs to roll out the vaccine there.

Some housekeeping notes. To those MPs who are contributing virtually: we will be able to see the clock on the screens in the Chamber, at the bottom of the right-hand side; you should be able to see the clock as well, and please try to finish before three minutes is up. It is a lot cleaner if you do that. To those contributing in the Chamber, the timer will be on the usual monitors in the Chamber, and there is a three-minute limit on all Back-Bench contributions.

Reciprocal Healthcare Arrangements

Edward Argar Excerpts

Thursday 17th December 2020 Written Statements

[The Minister for Health (Edward Argar)]

Today I am notifying the House about arrangements the Government have made to support people who require ongoing, routine healthcare treatment in order to be able to travel to the European economic area or Switzerland after the end of the transition period, should there be no further negotiated outcome with the EU. These arrangements would commence from 1 January 2021.

Current reciprocal healthcare arrangements enable large numbers of UK-insured individuals to access healthcare when they live, study, work or travel in the European economic area or Switzerland, and vice versa when European economic area or Switzerland-insured individuals come to the UK. Although some people are covered under the withdrawal agreement, for everyone else these arrangements will come to an end on 31 December 2020.

Negotiations on future arrangements with the EU are ongoing and include necessary healthcare provisions. If agreed, such provisions would provide effectively the same healthcare cover as the European health insurance card (EHIC). The Government continue to work hard to secure these arrangements.

In the event we have not reached an EU-wide agreement on reciprocal healthcare, the Government will implement a time-limited healthcare scheme that supports UK residents with ongoing, routine treatment needs, who are visiting the European economic area or Switzerland from 1 January 2021. This type of treatment was previously covered under the EHIC scheme.

This Government will introduce the scheme with the intention that it is used by individuals who are certain to require treatment while abroad, such as regular dialysis, oxygen therapy or certain types of chemotherapy. The Government recognise that these ongoing, routine treatment costs can be expensive, and makes travelling abroad extremely challenging for many people.

The scheme will be temporary and will cover travel that takes place between 1 January 2021 to 31 December 2021. People applying for the scheme must be ordinarily resident in England, Wales, Scotland or Northern Ireland and entitled to the treatment on the NHS. Individuals will need to work with their NHS clinician to agree their treatment requirements and confirm they meet the criteria in the scheme.

The NHS Business Services Authority (NHSBSA) will deliver this scheme for the whole of the UK. NHSBSA is an arm’s length body of the Department of Health and Social Care. It provides a range of critical central services to NHS organisations, NHS contractors, patients and the public.

The exception to the new scheme is travel to Ireland as the UK and Irish governments are committed that UK and Irish residents should continue have access to necessary healthcare when visiting the other country.

The Government will assess its options for reciprocal healthcare if we do not achieve an EU-wide arrangement. This includes the possibility of negotiating bilateral arrangements on social security coordination, including reciprocal healthcare, with individual EU member states.

The Department of Health and Social Care will publish further guidance on the scheme, its criteria and application process shortly.

[HCWS670]

Walthamstow Toy Library Eviction: NHS Role

Edward Argar Excerpts

Wednesday 16th December 2020 Westminster Hall

[The Minister for Health (Edward Argar)]

It is always a pleasure to serve under your chairmanship, Mr Hollobone. I will endeavour not to qualify for the Grinch’s green suit in what I am about to say to the hon. Lady. I congratulate her on securing this debate. It is always a pleasure to appear opposite her and she has always been a strong and vocal champion for her constituents in this House.

The hon. Lady has raised a number of points, and I am grateful to her for highlighting in advance the outline and contours of the issue, which means that I have had an opportunity to look into some of it. I will come back to this point later, but I make the offer that I am very happy, as soon as we return after the Christmas recess, to meet her to go into more detail about the issues she has raised and some of the history and chronology of what has happened here, if that is helpful to her.

I know the hon. Lady has been an active supporter of and campaigner for the Walthamstow toy library, which is an important local charity, and she started the campaign to save it from possibly having to move from the current premises, as she has talked about today. As she highlighted, the building is owned by one of the NHS local improvement finance trust companies, CHP, and that is one of the companies that is managed by the Department for Health and Social Care, or owned by the Secretary of State for Health and Social Care. It is now the head tenant for the property, having taken over from the PCT in 2013, when PCTs were abolished. CHP sublet to GPs and other providers of NHS services that received the majority of their income from the local CCG.

I note at the outset that the hon. Lady may wish to challenge some of these points when we meet, as she has done today. As has been related to me, in 2005, the toy library was incentivised to relocate to the new building following the destruction, for want of a better way of putting it, of its old building, by being offered a lease at a peppercorn rent, with a small contribution towards running costs for 10 years, which started on 27 September 2005. It occupies about 9% of the building.

That original lease was between the PCT and the toy library, meaning the PCT bore the cost. In 2013, when the lease was transferred to CHP and the local CCG, they agreed to honour that previous subsidy. My understanding is that during 2015 there were extensive negotiations between CHP, the toy library, the CCG and Waltham Forest children’s services on the expiry of the lease. It was recognised then by the CCG that the toy library would at the very least need time to review the options available to it and to explore securing alternative accommodation, other funding sources to increase its income or, for example, a contract for commissioned services from the council in order to pay its rent. As such, the CCG agreed to subsidise the occupancy for a further three years, beginning on 1 April 2015, at a cost of £50,000 per annum, with contributions also coming from the LIFT company and CHP for the balance of that.

By 2018, my understanding is that no progress had been made in sourcing alternative accommodation, and that the CCG agreed to a further three years of subsidising the rent on similar terms, continuing to contribute £50,000 per annum to costs, with a continued contribution from the LIFT company. The position of the CCG and the LIFT company is that this was always intended to be an interim measure for three years. They state that they sent a clear message to the toy library that, by March 2021, it was expected to pay the full cost of occupancy if it was to remain a tenant. The hon. Lady has put on the record a different interpretation of that, which I am happy to explore with her. If she wants to intervene, I will happily allow it.

[Stella Creasy]

It may be useful to clarify that at no point has the CCG told the toy library that it is to leave the building; indeed, the CCG keeps telling me that it is not evicting the toy library. More importantly, in the chronology that the Minister talks about, if the toy library had been told to find an alternative building, why was it working on commissioning services together with the CCG? I fear that the Minister has been sadly misled by Selina Douglas and the Waltham Forest CCG on this matter.

[Edward Argar]

I was about to make one final point, which is that I understand that a further three-month extension was agreed until 30 June 2021. However, I highlight what the hon. Lady said, not only just now but previously, which clearly suggests that a different complexion has been put on this issue. That is why my meeting her would be useful.

I will put on the record one or two points. It is important to note that the subsidy paid by the CCG is an arrangement that is not offered to any other charitable or voluntary group within the borough. I recognise, as the hon. Lady set out, the value that this charity brings. In my distant past when I was a Westminster city councillor, before I was a Leicestershire MP, I recognised the value that toy libraries and similar charities brought to the local community in London. I put that on the record because we must always remain conscious of fairness. There are specific circumstances, but I just wanted to highlight that point.

The hon. Lady talked about social prescribing, and she is absolutely right. That goes to my experience in seeing the huge value that charity facilities such as this can bring not only to those who are in need, but to others within the community more broadly who access the toy library and come together in that context. Such facilities are hugely important in the communities where they exist. They bring people together and provide mutual support, often to families and individuals who may not have a medical need, or who may not want their needs to be dealt with through medical means, but who find the support they need—help through a difficult time, or just more broadly—through such facilities. I recognise their value.

During the time that the toy library has been in this building, the CHP and the CCG suggest that a substantial debt for service charges and utility bills has accrued, which they assert that the toy library clearly agreed to pay as part of the original lease, separate from the rent. I see from the hon. Lady’s expression that that will feature in our discussion. I appreciate that there are different perspectives on the form that engagement has taken. CHP and the CCG have engaged with the toy library on a number of occasions to explore solutions to the issues that have arisen. Those solutions have included moving to a more sustainable business model, becoming a social enterprise or having the council commission services. They state that the toy library has been supported in those discussions to find alternative premises, with options explored including whether it could be relocated or co-located with other services for children and families.

The toy library of course has the first option on this space, certainly until the end of that period of extension, but I understand that, in the meantime, a feasibility study has been commissioned by the CCG on prioritising use of the building for health purposes. There are no signed agreements yet, but NHS parties state that they are reserving the right to reconfigure the building for what they deem to be its primary purpose: in their words, to get best value for the local health economy. However, to the hon. Lady’s point, we must always be conscious of the need to look at value not just in financial terms or in purely primary care terms, but in terms of broader health benefits and broader benefits to the community. Value, for want of a better way of putting it, takes many forms, not always with pound signs involved: there are broader, more intangible measures of value. Again, I am very happy to explore that aspect of the issue with her when we meet.

The view and perspective of CHP, the local CCG and the LIFT is that they have sought to engage constructively with the toy library since they first assumed that relationship—in 2013, if my memory of what I just said serves me—but they do need to look to the future. The suggestion of finding an alternative space at a similar peppercorn rent, for example, may be a way forward. However, I again note what the hon. Lady said: this is a purpose-built space for the toy library, and a shared space with others coming in and coming out would not necessarily work with the model for the services that are provided to the people who use it. I hope that as we look to the future, both the toy library and—equally, and hugely importantly—the CCG and CHP will try to engage, genuinely and openly, to explore options around either finance or genuinely viable alternative premises. I also hope that throughout, they will engage directly, and indeed courteously, with the hon. Lady as a representative of her constituents in this House.

The hon. Lady raised two specific points that I am happy to look at and discuss with her: one was about the IRR, and one was about levels of management fees. If she will permit me, I will take those away and look at them, and when we meet we can discuss those points.

This is a challenging situation, and clearly, some compromises may have to be made on both sides to move us forward. I have therefore already asked the CCG, CHP and the LIFT company to engage further with the toy library, openly and constructively, and to report back to me with a jointly agreed update on progress at the end of February. The hon. Lady has raised some significant issues, and I would hope to meet with her well before that stage, because I am keen to hear from her in a way that is not always possible in debates in this House. Although debates may raise the profile of an issue and highlight scrutiny of it, we can sometimes get into more detail in a private conversation. I am very happy to meet her and see whether we can find a constructive way forward that genuinely meets the needs of her community. Thank you, Mr Hollobone.

--- Later in debate ---

[Mr Philip Hollobone (in the Chair)]

Order. I am afraid that the hon. Lady is not allowed a right of reply. Generously, I will allow her to intervene on the Minister, if he agrees that he has not finished his speech, but the intervention has to be brief.

[Edward Argar]

Apologies; when I said “Thank you, Mr Hollobone”, I thought that I had caught your eye and you were about to stand, so I sat down. If I may, I will finish my conclusion, and should the hon. Lady wish to intervene on me, I am happy to take that intervention.

[Stella Creasy]

I thank the Minister for letting me intervene, and for the good Christmas cheer that he is bringing. Can I confirm that a side letter was sent by the CCG to the Walthamstow toy library in, I think, 2018, committing to paying all the costs of it being in the building? As such, the suggestion that charges were outstanding is another misleading statement. When he looks into the issue, could he also clarify who will own the building after 2030, when the original lease runs out? We are fewer than 10 years away, and surely any redevelopment of the building has to take place in that context.

I will very much take the Minister up on his offer of a meeting, because I think a way forward can be found to save the Walthamstow toy library where it is. I hope CHP and Waltham Forest CCG are listening very clearly, and that they will finally start to engage properly with my community. In view of that, I wish everybody a merry Christmas.

[Edward Argar]

I am grateful to the hon. Lady. If she is able and happy to forward me a copy of that letter—she may have to do so in confidence—I am very happy to look at it, because it will be useful for me to see it before we meet. She has raised a number of other questions; forgive me, because I did not pick up on that one when I answered. Again, in so far as I am able to discuss that issue with her, I will do so, and my office will get in touch with hers after this debate to try to get us a meeting in January. I hope that, as I say, we will be able to find a constructive and positive way forward that works for the NHS, for her community and for all parties involved, including the toy library.

Motion lapsed (Standing Order No. 10(6)).