Draft Tobacco Products and Nicotine Inhaling Products (Amendment) (EU Exit) Regulations 2020

Edward Argar Excerpts

Tuesday 3rd November 2020 General Committees

[The Minister for Health (Edward Argar)]

I beg to move,

That the Committee has considered the draft Tobacco Products and Nicotine Inhaling Products (Amendment) (EU Exit) Regulations 2020.

It is a pleasure to serve under your chairmanship, Mr Mundell.

At the outset, may I highlight that we should all recognise our cross-party achievements in respect of tobacco control legislation over the past two decades. They have brought smoking rates to their lowest on record in the UK, and the individual and public health improvements that that has driven for everyone. However, smoking still causes more than 78,000 deaths each year and is one of the leading causes of preventable illness and premature death in England. That is why we have set out an ambition for England to be smoke-free by 2030. We are developing our plans and we will share them as swiftly as we can.

As hon. Members will be aware, the United Kingdom is a global leader in tobacco control, and the regulations that we are debating today will ensure that we maintain that strong commitment to tough tobacco control legislation up to and beyond the end of the transition period.

Through the regulations before us we are making the necessary arrangements to implement the terms of the withdrawal agreement and the Northern Ireland protocol in law for tobacco control. That will ensure that the robust arrangements for tobacco control are able to function effectively from 1 January. The 2020 regulations will amend existing 2019 regulations, which were made in preparation for our exit from the European Union. With your permission, Mr Mundell, for simplicity I will refer to them as the 2019 regulations.

The amendments made by today’s statutory instrument to the 2019 regulations further amend how the Tobacco and Related Products Regulations 2016 apply in Great Britain and Northern Ireland after the end of the transition period.

The 2020 regulations introduce four main changes. First, it is essential that tobacco and e-cigarette producers provide notification of their products. That ensures that companies comply with legislation on product standards, and competent authorities are aware of all the products on the market. In accordance with the Northern Ireland protocol, the EU’s tobacco products directive will continue to apply to Northern Ireland after the end of the transition period. That means that suppliers of tobacco and e-cigarette products wishing to place a product on the market in Northern Ireland will continue notifying via the EU common entry gate system.

Those wishing to sell their products in Great Britain will be required to notify through a domestic system, as set out in the 2019 regulations. That domestic system is already developed and will be hosted by Public Health England, and its successor organisation, for tobacco products, and by the Medicines Healthcare Products Regulatory Agency for e-cigarette products. Despite a requirement to notify on two systems, that will place a minimal burden on industry as the notification format and information required will be extremely similar.

Secondly, to limit the financial burden on industry, the SI makes amendments to the Tobacco Products and Herbal Products for Smoking (Fees) Regulations 2017 and the Electronic Cigarettes etc. (Fees) Regulations 2016 to reflect that if a producer notifies via both the Northern Ireland and the Great Britain systems, they are only required to pay one fee. If a producer wishes to notify in relation to placing products on just one of the markets, the same one fee will be payable. We will, however, of course keep the fee structure under review. I am sure that the shadow Minister may wish to comment on that.

Thirdly, the SI places into law requirements for picture warnings, which are central to tobacco control. As a result of the Northern Ireland protocol, the EU’s library of picture warnings will continue to feature on tobacco products sold in Northern Ireland. However, our Government does not hold the copyright for the EU’s pictures for use on a Great Britain market. We therefore require the industry to switch to the picture warnings as set out in schedule A1 of the 2019 regulations, pictures kindly licensed by the Australian Government free of cost. The industry is already accustomed to supplying different markets with varying packaging requirements across Europe and worldwide.

Finally, the regulations amend the sell-through period for existing stock which feature the EU picture library on the Great Britain market in accordance with the withdrawal agreement. That will allow stock first supplied before the end of the transition period to continue to circulate until it reaches its end user.

The instrument will allow goods to move freely between Great Britain and Northern Ireland, subject to the tobacco picture warning requirements. We acknowledge that this will have some impact on industry. To minimise that, we communicated with stakeholders in August, making them aware of the legislative changes; we also circulated further guidance last month regarding the specific requirements for picture warnings. We are clear that it is important that industry has the guidance that it needs, and I know that it is a point that the shadow Minister raised in a similar context in a similar Committee yesterday afternoon. Public Health England and the MHRA will also be publishing detailed guidance on notification requirements for both notification systems later this autumn.

My officials have engaged with the devolved Administrations throughout the development of the SI and may I put on record, as I always do, my gratitude for their contributions, and the positive and pragmatic collaborative approach that has been adopted. Although tobacco legislation is largely a reserved matter, there was a particular devolved matter relating to Northern Ireland about e-cigarettes on which we are grateful to have gained formal consent from the Northern Ireland Executive.

In conclusion, the SI is a necessary measure to ensure that the withdrawal agreement and the Northern Ireland protocol are reflected in law for tobacco control purposes. It is essential that the robust level of tobacco control currently operating in the UK remains in place after the end of the transition period to ensure that we continue to protect the nation’s health. I therefore commend the measure to the Committee.

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[Edward Argar]

I will not dwell on what may be the triumph of hope over reality in the shadow Minister’s final comment. It is always a pleasure to appear opposite the hon. Gentleman, not only as a fellow east midlands Member of Parliament, but as part of our regular double act in these Committee Rooms. He is always pragmatic and highlights reasonable questions.

In terms of implementing the Northern Ireland protocol, and other aspects of the withdrawal agreement, the hon. Gentleman understandably raised the same question today as he did yesterday, and I am afraid that I will give him the same answer. The fact that he is here today, as am I, debating regulations on another aspect of the protocol should give him some reassurance that we will all play our part in the coming days to ensure that the protocol is delivered.

The hon. Gentleman also mentioned, as is his wont, the need to secure a good deal—a good future trade arrangement with the EU. I would remind him that we did of course secure such a deal with the withdrawal agreement—we left not with no deal but with that withdrawal agreement—but I take his point about the importance of the ongoing negotiations. As ever, it will not surprise him to learn that I will not prejudge what will emerge from them.

I agree with the hon. Gentleman about the importance of continuing to focus on tackling smoking and its consequences. We both highlighted the importance of what has been achieved cross-party, but of course there is no room for complacency, and we need to continue leading the way. He highlighted a recent report by Cancer Research UK; I confess that I have not read that full report, but it always produces extremely erudite and important documents, so I am happy to take that recommendation from him and read it.

The hon. Gentleman touched on local council services. In an endeavour to remain within the scope of the debate, I address that point more in the context of how those services and his points about them are important in setting the context in which today’s regulations sit. I served as a councillor for many years before entering the House, including for a period as cabinet member for health and adult social care, so I recognise the importance of council services to smoking cessation. I will of course flag that.

On the hon. Gentleman’s final point about the review of flavoured e-cigarettes, I will ask my colleague who has direct responsibility for that policy area, the Under-Secretary of State for Health, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), to update him in writing, if appropriate.

On the matter of divergence or otherwise, as I said yesterday, I have been in the House long enough not to be tempted by the hon. Gentleman to answer that question. It is a matter for future negotiations. We continue to lead the way, I believe, in Europe and indeed the world in tackling smoking. We will continue to do so in the future. The regulations are largely of a technical nature, but they will ensure that we can continue to protect people’s health, and that we have a strong tobacco regulatory regime in place after 1 January. I commend the regulations to the Committee.

Question put and agreed to.

Draft Nutrition (Amendment etc.) (EU Exit) Regulations 2020

Edward Argar Excerpts

Monday 2nd November 2020 General Committees

[The Chair]

Before we begin, I have to remind Members about social distancing. Thank you all for sitting in appropriate spaces, and I ask that all unmarked spaces please remain unoccupied. Hansard colleagues would be grateful if anybody who has speaking notes could email them to [email protected]. I call the Minister to move the motion.

[The Minister for Health (Edward Argar)]

I beg to move,

That the Committee has considered the draft Nutrition (Amendment etc.) (EU Exit) Regulations 2020.

It is a pleasure to serve under your chairmanship, Ms Nokes, I think for the first time, and to appear once again opposite the shadow Minister. I fear we are becoming something of a double act in these Delegated Legislation Committees.

The statutory instrument that we are considering concerns nutrition-related labelling, composition and standards, and follows on from SIs 2019/650 and 2019/651. Its purpose is twofold. First, it reflects the protocol on Ireland and Northern Ireland by amending the Nutrition (Amendment etc.) (EU Exit) Regulations 2019 and revoking the Nutrition (Amendment) (Northern Ireland) (EU Exit) Regulations 2019, which for brevity I will refer to as the 2019 regulations and the 2019 Northern Ireland regulations. Secondly, it remedies deficiencies in retained European Union nutrition legislation—that is, legislation that has come into force since March 2019 and therefore qualifies as retained legislation that must be incorporated.

As the instrument is technical in nature, I am sure that members of the Committee will welcome a brief summary of the regulations and the changes that we are making. The 2019 regulations were made in preparation for our exit from the European Union and will come into force at the end of the transition period. They will ensure that the regulatory framework for nutrition-related labelling, composition and standards remains functional throughout England, Scotland, Wales and Northern Ireland following the end of that transition period. They achieve that by making technical amendments to EU nutritional legislation, such as changing EU-specific references that will be redundant on exit day and transferring functions and powers currently held by the European Commission to the appropriate authorities in each of the UK’s constituent nations.

The primary purpose of today’s instrument is to give effect to the Northern Ireland protocol. Since the 2019 regulations were made in the context of planning for no deal, the withdrawal agreement has been agreed. Therefore, a revised protocol on Ireland and Northern Ireland has been agreed. In practice, that protocol requires that EU nutrition legislation is continued in its application in Northern Ireland while the equivalent EU legislation is retained or acquired in domestic legislation, as amended by the 2019 regulations in the nations of Great Britain.

The instrument therefore removes Northern Ireland from the scope of the 2019 regulations, omitting references to Northern Ireland and changing UK-specific references instead to read “Great Britain”, and prevents functions from being transferred from the European Commission to the Department of Health in Northern Ireland, as would have been the case in a no-deal scenario. The instrument also revokes the 2019 Northern Ireland regulations, which amended domestic nutrition legislation in Northern Ireland in preparation for the end of the transition period. Those amendments and revocations ensure that EU nutrition legislation continues to apply in accordance with article 5 of the Northern Ireland protocol in Northern Ireland, and that our obligations under that protocol are met.

The secondary purpose of the instrument is to remedy deficiencies in retained EU nutrition legislation, specifically concerning measures on infant formula and claims that can be made on pre-packaged food that have come into force since the 2019 regulations were made. The amendments are technical in nature—for example, removing references to the EU and its institutions that will no longer be appropriate following the end of the transition period.

The devolved Administrations have been fully involved in the drafting of the instrument at every stage, and I am grateful for their continued collaborative approach. I particularly thank Robin Swann in Northern Ireland and his officials for their efforts to ensure that this policy area will continue to operate in the right way and to the same standards as it does now following the end of the transition period. Indeed, the devolved Administrations have provisionally agreed a common framework for this area that aims to maintain existing standards and promote common approaches to nutrition policy in the future.

I am also pleased to say that we have worked openly and collaboratively with stakeholders more widely. A public consultation on the statutory instrument was held in July, during which a draft was made publicly available. We remain grateful to the broad range of stakeholders who responded, with the majority supportive of the approach to give effect to the protocol in the legislation, of the amendments to retained EU legislation, and of our assessment of the impacts.

Some respondents requested more detail on the processes with which industry will have to comply. The Government’s response to the consultation was published on 24 September, and my Department has updated the relevant EU exit guidance. Updated guidance is being tested with key stakeholders to ensure that it is fit for purpose, and it will be published on gov.uk later this month. I am confident that those documents will address any residual concerns that stakeholders may have.

As the instrument proposes no significant changes to the regulatory regime, we estimate that there will be no significant impact on industry or the public sector. In practice, although the protocol means that the legal basis for EU nutrition legislation applying will continue to be directly applicable in Northern Ireland, and the same legislation will not apply to the nations of Great Britain following the end of the transition period, the instrument, as I have emphasised, simply makes technical amendments to ensure that the regulatory framework remains functional through England, Scotland, Wales and Northern Ireland, and implements no policy changes. Nutrition-related labelling, composition and standards will therefore remain the same, in effect, throughout the UK.

Trade from Northern Ireland to the rest of the UK should continue to take place as it does now. There should be no additional process or paperwork, and there will be no restrictions on Northern Ireland goods arriving in the rest of the UK—that is, there will be unfettered access, as provided for by the protocol. Therefore, at the end of the transition period businesses in any part of the UK may continue to place their goods in any part of the UK internal market without new restrictions.

I reassure members of the Committee that the overarching aim of the SI is to provide continuity for business, to ensure that following the end of the transition period exceptional standards of safety and quality for nutrition regulation will continue across the UK, and to reflect the obligations under the Northern Ireland protocol. I commend the draft regulations to the Committee.

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[Edward Argar]

I am grateful to the shadow Minister, as always, for his tone, which is always reasonable and measured in these Committees. He will know that this is a technical amendment reflecting the fact that we signed a withdrawal agreement, and the Northern Ireland protocol was part of that. It reflects our commitment to deliver on that.

The shadow Minister spoke about the bigger picture. Negotiations are ongoing, and I would not wish to prejudge them. He is right to highlight the importance of the approach that has been taken. That applies to both sides, of course, and it is important that everyone negotiates openly and willingly and seeks to find a way forward. That is exactly what the Government are doing.

He talked about where we are on implementing other aspects of the Northern Ireland protocol pertinent to this Department, and about my responsibilities. As he rightly highlighted, it is important that we continue to work on implementing them, and I suspect he will have the pleasure in the coming months of more Committee meetings on delegated legislation such as this to reflect the other aspects of the Northern Ireland protocol that will need to be put into secondary legislation. He will see further developments on labelling, to which he referred.

He mentioned guidance and giving clarity to business. The updated guidance should be published later this month. There is already guidance, but it will be revised to reflect what industry said. We have increasingly put out updated guidance more broadly about the impact of the impending end of the transition period on different aspects of the Department’s work, and policy responsibilities that relate to Northern Ireland, the continuity of supply and a whole range of other things. We engage directly with the industry and individuals through a series of webinars, calls and a range of engagement activities. He is absolutely right that it is important to get the guidance up as soon as we can, which is what we are doing.

He asked about divergence. He is a colleague from the east midlands, and he knows that I am extremely fond of him, but I have been here too long to be tempted by him on that particular issue.

He asked about additional process, paperwork and burdens on industry. To reassure him, I repeat what I said in my opening remarks: there should be no additional process or paperwork flowing from this SI, so in our assessment there will not be a burden from it.

He also mentioned food labelling more broadly and the wider context. We are proud of our world-leading food health and animal welfare standards, not least those relating to nutrition. We will not lower our standards or put the UK’s biosecurity at risk as we negotiate new trade deals and as the transition period ends. We remain committed to promoting robust food standards, including nutritional standards, nationally and internationally to protect consumer interests.

I hope I have covered everything that the hon. Gentleman asked. If I have missed anything, I will, as always, drop him a note to cover it.

Question put and agreed to.

Covid-19 Restrictions: South Yorkshire

Edward Argar Excerpts

Wednesday 21st October 2020 Commons Chamber

[The Minister for Health (Edward Argar)]

With permission, I would like to make a statement on coronavirus, further to the statement made by my right hon. Friend the Secretary of State for Health and Social Care last night.

This virus remains a serious threat, and over a million people have tested positive for coronavirus in Europe over the past week. Here in the UK, we recorded 21,331 positive cases yesterday—one of the highest recorded daily figures. Average daily hospital admissions in the UK have doubled in the past 14 days, and yesterday we recorded the highest number of daily deaths, 241, since early June.

We must keep working hard, together, to keep this virus under control. We have been vigilant in monitoring the data and putting in place targeted local measures so that we can bear down hard on the virus wherever we see it emerging. We have seen how local action can help flatten the curve, for example in Leicester and Bolton. This targeted local approach, supported by our local covid alert level system, means we can have different rules in places like Cornwall, where transmission is low, from those in places where transmission is high and rising.

I would like to update the House specifically on the discussions we have been having with local leaders in South Yorkshire. The situation in South Yorkshire remains serious. There have been more cases in South Yorkshire so far in October—over 12,000—than in July, August and September combined. The number of patients with covid-19 in intensive care beds has reached over half the number seen at the height of the pandemic earlier this year, and the latest data suggests that the numbers of patients on mechanical ventilation will soon be comparable to the first peak in March. We need to act now to prevent the epidemic in South Yorkshire from continuing to grow.

I am pleased to inform the House that, following discussions this week, the Government have reached an agreement with South Yorkshire on a package of measures to drive down transmission. That means that South Yorkshire—so the city of Sheffield, Barnsley, Rotherham and Doncaster—will be moving to the local covid alert level “very high”, taking effect at one minute past midnight on Saturday morning. That includes the baseline measures to the very high alert level which were agreed by the House earlier this month.

As well as this, and as agreed with local leaders, unfortunately, casinos, betting shops, adult gaming centres and soft play centres will also have to close, and while gyms will remain open classes will not be allowed. On that point, the Liverpool city region and my hon. Friend the Member for Southport (Damien Moore) have also requested to bring their region into line with those measures. So gyms will be open and soft play centres will close in the Liverpool city region.

We know that some of the measures I have announced today are challenging and will have a real impact on people and businesses in South Yorkshire, so we will be putting in place substantial support. That includes the job support scheme, which ensures those affected by business closures are still paid. Once topped up with universal credit, those on low incomes will receive at least 80% of their normal income. The agreement also includes additional funding of £11.2 million for the local area for local enforcement and contract tracing activity. As well as that, we are putting in place extra funding so that local authorities in South Yorkshire can continue to support businesses through this period.

From the Dispatch Box, I would like to thank all the local leaders in South Yorkshire for the collegiate and constructive way in which they have approached the negotiations. I would like to thank all hon. Members representing constituencies in the region as well. We have worked across party lines to reach an agreement that will protect public health and the NHS in South Yorkshire, while also supporting those who need it most. I know those local measures will be hard and entail further sacrifice, but through bearing down hard on the virus, wherever and whenever we see it emerge, we can help to slow the spread of this virus and protect our loved ones and our local communities. The agreement will help us to protect lives and livelihoods in South Yorkshire and I commend the statement to the House.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Minister of State for advance sight of his statement. Today, we have another great swathe of the north put into lockdown. Sheffield went into tier 2 restrictions last Wednesday, so did Ministers make the wrong judgment a week ago or has new evidence come to light that was not apparent last Wednesday? How many other areas in tier 2 today are facing the same fate as Sheffield, such as those areas in tier 2 that neighbour South Yorkshire, such as North East Derbyshire or Nottinghamshire?

The Secretary of State could not answer yesterday the question of how long Greater Manchester will be in lockdown, or what the criteria will be for leaving lockdown, so can the Minister of State today tell us how long South Yorkshire will be in lockdown? Does the nationwide R number need to fall below 1, as the Prime Minister suggested last week, or just the regional R number? Or, if an area such as Doncaster gets the R below 1, will it be able to leave lockdown?

The Prime Minister at the Dispatch Box earlier talked about hospital admissions, so could the Minister tell us what level hospital admissions need to come down to for an area to exit lockdown?

As I said yesterday, my dad worked in casinos in Salford and my mum worked in bars. I know people will want to do the right thing and will understand that further measures are necessary to contain the spread of the virus, but families should not face financial ruin. The Minister wants congratulations for the package he has allocated to South Yorkshire, but why is contact tracing funding subject to the negotiations and deals? The virus is out of control because of the failures of the £12 billion test and trace system. If local areas had been given the resources months ago to put in place effective contact tracing, we would not be in this situation now. Those failures on contact tracing are having a direct impact on people’s lives.

This afternoon, families across South Yorkshire who work in hospitality—whether in Doncaster, Sheffield, Penistone, Rother Valley or Don Valley—will be asking why, if it was fair to pay 80% of wages in March, they should now be expected to get by on just two thirds of their wages in the run-up to Christmas. This matters to families everywhere, because we know that further restrictions will be needed. Indeed, according to sources briefing Times Radio, plans are being developed for a three-week lockdown more widely next month. Perhaps the Minister could confirm that his officials are now working on plans for a three-week national lockdown next month.

The Communities Secretary said this morning that there was now a national formula for areas under local lockdown, but Ministers say they want a targeted local approach because circumstances vary. Yet when an area such as Greater Manchester, which has had restrictions since July, says, “Our circumstances are different,” the Prime Minister says, “Tough. Hard luck. You can’t be treated any differently,” and vindictively refuses Greater Manchester just £5 million extra to get a deal over the line. This is playing politics with people’s jobs and people’s livelihoods. We cannot defeat this virus on the cheap, nor should it be broken on the backs of the lowest paid. Public health restrictions must go hand in hand with economic support, because as night follows day, falls in employment lead to rises in chronic illness. The Chancellor must pay out to help out, and deliver a fair deal to support jobs and livelihoods under lockdown.

[Edward Argar]

I am grateful to the hon. Gentleman, my constituency neighbour up in Leicestershire. He was, as usual, typically reasonable and measured, until almost the last moment, when I am afraid the only person playing politics was him.

To address the hon. Gentleman’s points, we are taking these steps now, at the right time, as the infection rate has continued to go up. In respect of other tier 2 areas or neighbouring tier 2 areas, it is only this announcement that we are planning to make at this point. It is the only move that has been announced and that is currently being considered.

The hon. Gentleman asked about criteria, essentially— a number of his questions were, “How long for?” and, “How will it be judged?”, which are fair questions. Areas will remain in tier 3 or tier 2 for as long as necessary to protect the health of the local people and the NHS in that region. He asked about the sort of things that will be relevant to when an area enters and comes out. These include infection rates per 100,000, the impact on the NHS in terms of hospital capacity and how full hospitals are, and hospitalisation rates, as well as relying on local knowledge and listening to local public health officials, as he would expect us to.

The hon. Gentleman touched on contact tracing and how that is working. What we have in this country is a blended system, which brings together the scale of a national approach with the local knowledge provided by local public health teams. He has seen in his own city of Leicester how effective that can be and how both parts are absolutely vital.

The hon. Gentleman finished by talking, I think reasonably, about the need for economic support for those affected by this. As I set out in the statement, the job support scheme, coupled with universal credit for those eligible, will ensure that people receive at least 80% of their wages. On his broader point about the big picture of economic support, I would remind him that this Government and the Chancellor have provided an unprecedented package of economic support over recent months to businesses and individuals. The Government are very clear in our commitment to protect the health of this nation and the economic health of this nation.

[Nick Fletcher (Don Valley) (Con)]

I thank my hon. Friend for making this statement. I have had many productive meetings with him and his colleagues in the Department of Health and Social Care during the pandemic, and I know how hard such decisions are to make. While I understand the necessity for South Yorkshire to go into tier 3 to reduce the infection rate, businesses and employees are worried about the future. Can he confirm to the people of Doncaster that if they play their part, they will be able to move down to tier 2 independently of Sheffield city region?

[Edward Argar]

My hon. Friend is a consistently strong voice for his constituents in this House and in conversations with Ministers. I am clear, as are the Government, that no area should remain in a tier longer than is absolutely necessary to address the infection rate and protect the health of local people, so I can give him the reassurance that his area will stay in that tier no longer than is necessary to address the current rise in hospitalisations and infections.

[Martyn Day (Linlithgow and East Falkirk) (SNP) [V]]

I am grateful to the Minister for advance sight of his statement, and I agree with him when he says that we must keep working hard together to keep this virus under control. However, I cannot help but notice that regional leaders in England have been expressing frustrations with Downing Street that are very similar to Scotland’s. Why is there an insistence on announcing measures to Westminster journalists before speaking to devolved and regional Governments? Does he not see that changing that approach could greatly improve working relationships?

Tens of millions of pounds of financial support are being announced this week. Will the Minister speak with his colleague the Chancellor and confirm that that money will be fully Barnettised, ensuring that the devolved Governments are being fully funded to take their own covid mitigation measures?

[Edward Argar]

I am grateful to the hon. Gentleman. I should say that in my experience, albeit as a junior Minister, I have enjoyed a positive and constructive working relationship on this issue with the devolved Administrations and Ministers in Scotland, Wales and Northern Ireland. I pay tribute to that relationship and the work that those leaders in the devolved Administrations have done.

I turn to the hon. Gentleman’s final two points. In respect of his comments about briefings, all I would say is that I am here at the Dispatch Box announcing this to the House, and that is how I do business. On his final point, the Chancellor will, I know, have heard exactly what he said about Barnett consequentials.

[Miriam Cates (Penistone and Stocksbridge) (Con)]

None of us in South Yorkshire wanted to be in this position and, as hon. Members have already said, this is going to hit families, businesses and communities hard at a time when we are already weary of months of not seeing family and friends. But it is important that we take swift action to protect the NHS and prevent local NHS services from becoming overwhelmed. I really do want to pay tribute to our Mayor Dan Jarvis, local leaders, No. 10 and the Department of Health, who have taken a really calm, constructive and collaborative approach over the past few days. That shows that we do not all hate each other in Yorkshire, despite the common perception.

I am also pleased that the restrictions are not open ended and that there is the 28-day review. I appreciate that the Minister cannot give exact metrics about what will be used to determine whether or not we come out of this, but it is very important to my constituents in Penistone and Stocksbridge that we know what we are aiming for. Can he guarantee that he will have regular, ongoing discussions with local leaders and local people about whether we are heading in the right direction, to make sure that people know that we are on the right track?

[Edward Argar]

I should have done this in responding to the shadow Secretary of State, actually: I also pay tribute to the Mayor of Sheffield City Region—a Member of this House—for his approach and to the constructive approach that we have seen on all sides in this. I put that on the record.

My hon. Friend talks about local engagement and what hope there is of reviews. The 28-day period is the sunset point at which these measures fall, unless they are renewed or altered. There are actually reviews within 14 days; the Secretary of State continues to monitor data so will be reviewing progress at more frequent intervals. I happily give my hon. Friend the assurance that she seeks: throughout this process there will be open lines of communication—not only with her and other colleagues, but with local leaders in the region.

[Olivia Blake (Sheffield, Hallam) (Lab)]

Although I am horrified that we are at this position, I completely understand the need for the introduction of these measures; I hope that everyone in South Yorkshire will follow them constructively. However, we need a level of support across the country to ensure that these local measures work. Although I am pleased that we have had constructive conversations throughout this period, I am still concerned that too many people will be left behind.

I have already heard from one employer about their employees falling through the cracks of the support scheme. They are unable to access funding for childcare on the basis of this as well. The lowest paid also use universal credit as an in-work benefit. Will the Minister agree, accept and make representations to the Treasury that perhaps 80% of an income topped up by universal credit is not enough in these scenarios?

[Edward Argar]

I am grateful to the hon. Lady for the tone of her initial remarks—she is clearly putting the health interests of her constituents first—and her perfectly reasonable question. As I set out in my statement, the job support scheme, coupled with universal credit, will give those on low incomes at least 80% of their normal income, but if there is a specific sector or case that she wants to raise, I would be delighted for her to write to me, and I will look into it.

[Alexander Stafford (Rother Valley) (Con)]

None of us in South Yorkshire wanted to be in the higher tiers, but we completely understand the need to save lives and protect the NHS; that is the overarching thing that we need to take away and encourage all our population to do. However, this increased tier will have an increased impact on people’s mental health. I have already been contacted today by constituents who are seriously worried about their mental health, especially when they do not have anyone to form a support bubble with. What assurances can the Minister give to me and people across Rother Valley that mental health is a key part of the system and will be looked after and helped?

[Edward Argar]

My hon. Friend is absolutely right. I have known him for many years, and he has long taken an interest in and campaigned on this issue. I can reassure him that additional investment has gone into the NHS at all levels, which includes mental health, but he is right: the impact of lockdown and these restrictions on people’s mental health should never be underestimated, so it is right that support and advice are available to people. I know that his local NHS is working very hard to ensure that that package is in place. If he wishes to talk to me subsequently, I am happy to do that.

[Paul Blomfield (Sheffield Central) (Lab)]

Clearly we have to take the measures necessary to combat the virus, and we have tried to work together on them across South Yorkshire, but the Minister knows that this deal does not meet all the concerns of local leaders, nor does it provide the support that businesses need. The ban on household mixing is clearly necessary, but it makes many cafés, restaurants and pubs with food unviable. It impacts on the music, events and creative sectors, but because they are not being required to close, they will not get the support they need. They are simply being hung out to dry. Will the Government think again and provide the support that those businesses need, to save thousands of jobs across South Yorkshire?

[Edward Argar]

The hon. Gentleman is always diligent and measured in representing his constituents and businesses in the House. The deal that has been reached is both fair and proportionate and reflective of the fairness across other areas that are in tier 3, and it should be taken in the context of being coupled with the broader national programme. I would not characterise the approach being taken towards hospitality in the way that he did. I pay tribute to our hospitality industry in this country, which I think is what he was seeking to do, and as I say, the support package is there to support businesses across all sectors in this country.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

Test and trace activity is rightly focused on areas of the country where there is relatively high transmission of the virus. To what extent will the Minister prioritise tier 3 areas over tier 1 areas in the protocols that the Department is drawing up for vaccination?

[Edward Argar]

The protocols for the distribution of any vaccine, when it becomes available, are being worked on intensively. My right hon. Friend makes a good point, which I am sure will have been heard by the Secretary of State.

--- Later in debate ---

[Dan Jarvis (Barnsley Central) (Lab) [V]]

As Mayor, I think that this is the right course of action for South Yorkshire. The financial support will provide some help for our people and our economy, but we all understand that it will also mean sacrifice. Families will be separated, workers will suffer, and businesses will face uncertainty, so we need the Minister and the Government to repay that sacrifice by working closely with us, with our local authorities and with our NHS. Together, we need to do everything we can to get a grip of this disease, so that our region can move out of these restrictions as soon as possible.

[Edward Argar]

I reiterate the tribute I paid to the hon. Gentleman for his approach throughout this. It is abundantly clear that he and all of his colleagues have the best interests of his region at heart and have worked constructively throughout this process to get the right health and economic outcome for his area. I can absolutely give him that commitment. I and my colleagues look forward to continued close working and co-operation with him as we move forward to beat this disease in his area.

[Steve Brine (Winchester) (Con)]

The three-tiered local approach has to be right, and I pay tribute, as the Minister just did, to the cool heads of some local leaders for working with Ministers so sensibly. Surely people in South Yorkshire and elsewhere need to know where they are at and be confident that the goalposts will not move, so can the Minister please comment on stories this morning that plans are being worked up by the chief medical officer for local—not national, but local—three-week circuit breaker lockdowns in tier 2 and tier 3 areas?

[Edward Argar]

I can reassure my hon. Friend that that is not something I have been involved in or had sight of.

[Munira Wilson (Twickenham) (LD)]

Public trust in the midst of a public health emergency is absolutely critical. People need to know what they are working towards when they are making these immense sacrifices, so may I press the Minister once again on the criteria that he has agreed with the Mayor of Sheffield city region for South Yorkshire going into tier 3 and to come out? Will those same criteria be applied to other tier 2 areas such as London, York, Essex and parts of the midlands, or will they all be subject to a series of negotiations at local level behind closed doors? The public need and want to know.

[Edward Argar]

I am grateful to the hon. Lady, who is her party’s spokesperson on this issue. I entirely understand where she is coming from and the importance of trust and transparency. I set out in the statement why the move has been made to increase the tier level—the infection rates and the hospitalisation rates—and why that development needed to be arrested by these measures. I set out in response to the shadow Secretary of State the considerations that would play a part in determining the review periods when an area could start to move back down those tiers. Those things include infection rates, the impact on the NHS and hospital capacity in the area and other local factors. It is reasonable that we set out that broad approach, but also that we recognise that in some areas very specific local considerations will be driving growth of the disease and infection rates, and they may need to be taken into consideration as well.

[Sir Edward Leigh (Gainsborough) (Con)]

If someone lives in Gainsborough and they want to take a test, they can go to the Lincolnshire showground, but equally they might go to Doncaster airport, if their work takes them up there and it is not much further. There is a mystery about infection rates in West Lindsey, because they are higher than all the surrounding areas, despite the fact that we have no university, we are a rural area and we have no large hospital. I suspect the figures are being corrupted because the large local testing site is at the Lincolnshire showground. Cases are probably coming in from outside and featuring in West Lindsey figures. That is important, not just for South Yorkshire but for everywhere else, because if those figures are wrong, how can we rely on them? How can we lock down areas and put businesses out of business if the figures simply do not add up?

[Edward Argar]

I am not aware of any systemic issue that is seeing false data entered, but if my right hon. Friend is happy to give me more information, I am happy to look into it for him. There can, though, be other factors beyond universities or a young population. There can be a range of things in a particular area that drive a particular spike, but I am happy to look at the information he has got.

[Jim Shannon (Strangford) (DUP)]

I completely understand the reasons for this statement. Government action for Yorkshire is similar to the action we have taken in Northern Ireland with the circuit breaker. Simon Hamilton, chair of the Belfast chamber of trade and commerce, has stated, in tandem with 23 other organisations that “fewer and fewer” will survive each lockdown and

“more jobs will be lost”.

The Department for the Economy accurately estimates that those job losses could be 100,000. With the prospect of longer dole queues and poor prospects for re-employment, what discussions have taken place and what assistance can the Minister give to the devolved Administration in Northern Ireland?

[Mr Speaker]

The statement is about South Yorkshire. I would have thought that the hon. Gentleman would have had a little bit of something about Yorkshire. Minister, see what you can pick out of that about Yorkshire.

[Edward Argar]

I am pleased to reassure the hon. Gentleman that the same collegiate approach we have adopted for working with South Yorkshire characterises our approach across all of the devolved Administrations and devolved nations as well. May I say to the hon. Gentleman that we missed him while he was away self-isolating for a period, so it is good to have him back? He touches on the economic impact, and he is absolutely right to highlight that. There is a clear support package in place, and I continue to work closely with Robin Swann and others in Northern Ireland on these matters.

[Scott Benton (Blackpool South) (Con)]

Last week, local politicians in Lancashire were able to put their politics aside and work constructively to agree a sensible way forward. I am delighted that politicians in South Yorkshire have now been able to replicate the same constructive cross-party approach. Will my hon. Friend commend those local politicians, including the hon. Member for Barnsley Central (Dan Jarvis), for the way in which those negotiations have been conducted, which has of course been in stark contrast to the behaviour of some other elected Mayors?

[Edward Argar]

I join my hon. Friend in paying tribute to all local leaders and, indeed, all Members of this House who have been engaged in this process and more broadly. It is clear that when we all work together, we can achieve more to tackle this disease.

[Bill Esterson (Sefton Central) (Lab) [V]]

On Monday, I asked the Health Secretary about contact tracing. He answered by talking about testing, so perhaps this Minister will answer a question about contact tracing. Will the Government now give the Serco data to local public health teams, and will the Government provide the financial resources that those local teams need? That equates to roughly £300 million to the Liverpool city region, similar sums to Lancashire and to South Yorkshire, and about £500 million to Greater Manchester when compared with the £12 billion for Serco.

[Edward Argar]

I am grateful to the hon. Gentleman. The data he refers to is, of course, Government data—NHS data. He talks about contact tracing, and as I said in response to his hon. Friend the shadow Secretary of State, the approach we adopt on both testing but particularly on contact tracing quite rightly blends the scalability of a national approach with the local knowledge of working very closely hand in hand with local public health teams. A very good example of how that can work well is in my own local city and the shadow Secretary of State’s city of Leicester.

[Robbie Moore (Keighley) (Con)]

These really are tough choices, as nobody wants to see their lives restricted or their freedoms curtailed. All of my constituents in Keighley and Ilkley have had local restrictions since the end of July, and for now at least we are in tier 2. While many are adhering incredibly diligently to these restrictions, it is clear that a sense of disenfranchisement is kicking in, with some not adhering. How can we better address this so that we give ourselves the best chance of staying in tier 2 and not going up to tier 3 like our neighbouring friends in South Yorkshire?

[Edward Argar]

It is very important that everyone continues to adhere to the rules put in place for the tier in which their area sits. Those rules are in place to protect public health and bring the infection rate down. I would, finally, comment—I think it was the Liberal Democrat spokesperson, the hon. Member for Twickenham (Munira Wilson), who mentioned trust—that of course it is very important for building trust and consent that we work closely with local leaders and with local Members of Parliament, and I come to this House, as I have done today, to obtain that consent and provide that transparency so that people are more likely to comply.

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

I note the agreement reached in South Yorkshire, and I fear that York is rapidly heading in the same direction, with a sharp increase in infection. Does the Minister recognise that each local authority has different economies, different complexities and different vulnerabilities, and therefore it is really important to start dialogue early with local political leaders as well as ourselves to get the right deal to prevent an escalation in tiers, but also to ensure that we get on top of the Track and Trace system to make sure that that is done locally and is effective?

[Edward Argar]

I am grateful to the hon. Lady. I think she actually made the case very well for the approach that the Government are adopting, which is local tiering, rather than a blanket national approach, because she is absolutely right that different areas of the country are different and have different circumstances. To her substantive point about early engagement and continued engagement, I am very happy to say that I am very happy to work with her. We can start that off, if she wants, with a conversation about the data and so on. I am very happy to ensure that those channels of communication are open.

[Mr Mark Harper (Forest of Dean) (Con)]

Enforcement is important in South Yorkshire, as it is elsewhere, and I am pleased that on today’s Order Paper there is a statutory instrument putting the requirement to self-isolate in law. However, the Minister will be aware that I have grave concerns about the powers to use reasonable force that have been given to state officials other than police officers who simply are not trained to use those powers safely. As a former Home Office Minister, I think that risks the safety and lives of individuals. May I ask the Minister to give me an assurance from the Dispatch Box that, at the earliest opportunity, those powers will be limited only to police officers? I regret to say that if he cannot give me that assurance, I will be unable to support the measures on today’s Order Paper.

[Edward Argar]

I am grateful to my right hon. Friend for his question, and I am conscious of the context in which he speaks. As a former junior Minister handling prisons at the Ministry of Justice, I am conscious of the issues that he alludes to in that context and of the importance of proper training and restraint and similar. We appreciate concerns about the reasonable force allowances in the regulations. The powers to authorise persons other than the police and police community support officers to use reasonable force have not been used, and there are no intentions to use them. However, my right hon. Friend makes his point well, as always, and we are urgently reviewing those powers, given the concerns that he and others have raised around the proportionality of enforcement.

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

This morning, Professor Edmunds told the Health and Social Care Committee and the Select Committee on Science and Technology that he would not follow the strategy of imposing tier 3 lockdowns on a succession of local areas. He said that would keep the R number around 1, meaning that the high rate of incidence we already have in those areas, with hospitals under strain, would just continue. Instead, a short circuit breaker, with tier 3 restrictions everywhere now, is what we were told would bring case rates down. If that is the advice being given to the Government, why are they pursuing damaging restrictions on areas such as South Yorkshire and Greater Manchester, with inadequate financial support, that are unlikely to bring cases down?

[Edward Argar]

I hope that the hon. Lady will forgive me; I did not see the evidence to the Select Committees, as I was preparing to come to the House. However, as she will be aware, the SAGE paper that was published recently, in referring to so-called local circuit-breaker lockdowns, did not say it was a one-off and would solve the problem. We are confident that we are taking a proportionate and effective approach on a regional and local basis that will, assuming that compliance is there, continue to drive down infection rates effectively, coupled with an effective economic and financial support package agreed with local leaders.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

Although my thoughts are with the people of South Yorkshire and businesses in South Yorkshire, my primary responsibility is to people in North Yorkshire. Will my hon. Friend help to scotch any rumours that are circulating that North Yorkshire is about to go into tier 2 when its rate of infection is well below the national average? If there is any need to put us in a higher tier, will he look to do that on a district-wide level, where there is significant variation across North Yorkshire, rather than purely at county-wide level?

[Edward Argar]

If I recall correctly, I believe that my right hon. Friend the Secretary of State was able to offer my hon. Friend a reassurance relatively recently in the House in respect of the approach that he was looking to take in that context, and that still stands.

[Andrew Gwynne (Denton and Reddish) (Lab) [V]]

The Minister has, no doubt, given briefings to South Yorkshire colleagues, as he did with Greater Manchester MPs earlier this week, and I sincerely thank him for that engagement. It is being widely reported that the Communities Secretary is meeting Greater Manchester’s MPs about the next steps for our city region. Sadly, it seems that none of the 18 Labour MPs has received an invite. Is that an accidental oversight or further evidence of increasing ambivalence towards our city region?

[Edward Argar]

I can reassure the hon. Gentleman that there is no ambivalence towards his city region. There is a deep respect and affection across this House for that region and the people who live there. I am grateful to him for his kind words about the briefing I led with colleagues across all parties relatively recently on this. I am happy to look into the specific question he raises about being briefed by the Local Government Secretary.

[Jacob Young (Redcar) (Con)]

I pay tribute to the Mayor of South Yorkshire, the hon. Member for Barnsley Central (Dan Jarvis). He has worked constructively with the Government to ensure proper northern leadership in the interests of public health. Will the Minister confirm that when other areas face changes to local restrictions, his Department will continue to work with local leaders and Members of Parliament? Will he also confirm that there are no plans to move the Tees Valley, and specifically Redcar and Cleveland where cases have recently dropped, into tier 3?

--- Later in debate ---

[Edward Argar]

My hon. Friend is right to talk about the importance of local leadership and engagement. Local leaders and Members of Parliament know their areas best, and it is right to continue to engage closely with those people. I join my hon. Friend in paying tribute to the work that has recently been done in that respect. On his final point, I am not aware of any such proposition.

[Alison Thewliss (Glasgow Central) (SNP) [V]]

People in South Yorkshire, as well as in my constituency, struggle to make ends meet on the UK Government’s pretendy living wage, which falls far below the real living wage. How does the Minister expect people to live and pay their bills and rent on only two-thirds of that poverty pay?

[Edward Argar]

As the hon. Lady will have heard me say, the combined support schemes, particularly where there is the UC top-up, will mean that people get at least 80% of their wages. I am afraid that I refute her point about the living wage in this country, as I believe it is a significant achievement by this Government and the previous Chancellor, George Osborne. It is a huge step forward, and rather than belittling it, we should recognise the impact it has had.

[Martin Vickers (Cleethorpes) (Con)]

South Yorkshire is where many, perhaps most, visitors to Cleethorpes come from. They are very welcome and vital to the local hospitality sector, but many of them occupy caravans and chalets for weeks and months at a time. Again, that is welcome, but there are concerns among local people that people perhaps come and go during this period to and from an area in tier 3. What support can the Government offer to the local authority to monitor that?

[Edward Argar]

My hon. Friend highlights an important point, and we have been clear that people in tier 3 areas should not undertake travel in and out of that area. They should abide by the rules of the area in which they live, rather than travelling to another area and applying the rules in that area. The rules apply on the basis of the area in which someone lives.

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

One big concern about the local lockdowns in South Yorkshire and elsewhere is that if there is not enough money to support businesses to survive, there will be a longer-term impact on the economy and individual livelihoods if that is not put right. That will have a big impact on public health, and one of the biggest concerns is the loneliness of people living in single households, and the impact on their mental health. How is the Minister looking ahead—I hope that he will answer this point directly—to ensure that there is no long-term oncost to the health service from this misery for people who are left alone and are now unable to mix with households in South Yorkshire and other areas with hard lockdowns?

[Edward Argar]

The hon. Lady makes an important point about loneliness and its impact on mental health. She will know that support bubbles still exist, but she alludes to a broader point about long-term mental health support. As I said in answer to my hon. Friend the Member for Rother Valley (Alexander Stafford), we have invested heavily in the NHS, which includes funding for mental health support services. The hon. Lady is right: this is not just about funding during this pandemic; this is about being aware of people’s long-term needs and the impact on them. I am happy to commit to considering that issue carefully in the months and years ahead.

[Matt Vickers (Stockton South) (Con)]

These tough measures will have a huge impact on the lives of local people. Can my hon. Friend assure me that the Government will do everything they can to provide an extensive package of support to local people, businesses and councils and that his Department will continue to do everything it can to avoid the need for such a lockdown in Stockton South?

[Edward Argar]

I can give my hon. Friend exactly that assurance.

[Tim Farron (Westmorland and Lonsdale) (LD)]

The hospitality and tourism industry in Cumbria is comfortably our biggest employer. It was very much looking forward to half-term next week, as a chance for businesses to pick up after the enormous damage they have sustained as a result of the virus. However, we are seeing cancellation after cancellation, because neighbouring economies in Lancashire, Greater Manchester, Merseyside and now, of course, other parts of the north England have been put into tier 3 and people are therefore not able to travel. Rather than quibbling over £5 million, people in Cumbria are getting nothing—no compensation for their businesses collapsing. Will the Minister commit to making sure there is support of the hospitality and tourism industry in tier 1 places such as Cumbria, where our market has dried up because our neighbours are in tier 3?

[Mr Speaker]

This is about Yorkshire, so if we could mention Yorkshire it would help.

[Edward Argar]

I am sure the point the hon. Gentleman raises will be pertinent to areas in tier 1 nearby to South Yorkshire, too. He makes his point typically well. I recognise the impact on the hospitality industry and on other businesses, not just in the directly affected area but more broadly. As I say, he makes his point well, and I am sure the Chancellor will have heard what he says.

[Robert Largan (High Peak) (Con)]

None of us wants to see restrictions like those announced for Yorkshire today, but we all recognise the need to prevent the NHS from being overwhelmed. However, I am increasingly concerned about the long-term health impact the pandemic is having on things like mental health and long-term serious health conditions. A good example is the recent commissioning decision by NHS England to withdraw breast cancer screening units from places such as New Mills, Buxton and Chapel-en-le-Frith, citing covid as the reason for the withdrawal. Will the Minister agree to meet me, so we can discuss how to reinstate breast cancer screening units to High Peak?

[Edward Argar]

I, or a fellow Minister from the Department, will be very happy to meet my hon. Friend.

[Peter Kyle (Hove) (Lab)]

Local and regional authority leaders from South Yorkshire and right the way across the country will have heard the Health Secretary and the Prime Minister repeatedly say in the past 24 hours that they cannot exceed the items offered to Merseyside in their negotiations elsewhere. Will the Minister at least be honest and say that this is not a negotiation? It is a take-it-or-leave-it deal that other authorities can take. Those who lead authorities have to ask themselves the question: what is the point of negotiating?

[Edward Argar]

The hon. Gentleman knows I have huge respect for him—indeed, a huge fondness for him —but I am afraid I cannot agree with what he says. We have been working very closely in a collegiate way with local authorities. It is absolutely right that, alongside that negotiation or discussion on the package and support they need, we recognise that we have to be fair and proportionate across other regions that are in the same tier. We have to ensure that the approach we are adopting, which we are, is both fair and proportionate.

[Lee Rowley (North East Derbyshire) (Con)]

North East Derbyshire sits on the outskirts of South Yorkshire and many towns and villages, such as Dronfield, Eckington, Killamarsh and Ridgeway, look towards Sheffield for work and education. For the benefit of those residents, will the Minister confirm that there has been no change to the tier level in North East Derbyshire, that the rules remain the same unless those residents are travelling to Sheffield and that North East Derbyshire will continue to be dealt with on an independent basis, while working closely with Sheffield when we review our tier status in future?

[Edward Argar]

As my hon. Friend knows, I know Dronfield having spent a very happy day there with him in the course of his successful election campaign. I can reassure him that the situation, as I stand here, remains exactly as he sets out.

[Mr Speaker]

In order to allow the safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the next, I am suspending the House for three minutes.

Botulinum Toxin and Cosmetic Fillers (Children) Bill

Edward Argar Excerpts

2nd reading & 2nd reading: House of Commons
Friday 16th October 2020 Commons Chamber

[The Minister for Health (Edward Argar)]

It is always a pleasure to see you in the Chair, Madam Deputy Speaker.

First, as hon. Members will hopefully recognise, I am not my hon. Friend the Member for Mid Bedfordshire (Ms Dorries). I know that she would very much have wished to be here today, given her work with my hon. Friend the Member for Sevenoaks (Laura Trott) on her Bill. She has asked me to say that, as a close contact with someone who has tested positive for covid, she is, as always, doing the right thing and staying away from the House.

I thank my hon. Friend the Member for Sevenoaks for her efforts in bringing forward this Bill today. I know that my hon. Friend, who is the Minister for Patient Safety, Mental Health and Suicide Prevention, has had many positive conversations with her about this issue.

I recognise, given the amount of time that we have been spending opposite each other in debates in recent days, that the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), has picked up on some points that I was already going to pick up on—I suspect that that comes as no surprise. He is right to highlight that this is an issue that unites the House, regardless of party. It is important that I join him in paying tribute to the hon. Members for Swansea East (Carolyn Harris), for Bradford South (Judith Cummins) and indeed to the right hon. Member for North Durham (Mr Jones), who has also taken a big interest in this issue. I also pay tribute to very powerful campaign of The Sun.

Turning to my hon. Friend the Member for Sevenoaks, I know her well and I have known her since before she was a Member of this House. She is always eloquent and effective in her campaigning, and she truly cares about these issues, so it is a privilege to speak in this debate. I also know, from her campaigning, her determination to achieve results and that she always does so. With that in mind, it is a pleasure and, indeed, a relief that, on behalf of the Government, I can offer my wholehearted support for the introduction of an age restriction for cosmetic procedures, and I hope that this Bill—this very important Bill—will receive the wholehearted support of the House.

Let us be clear, this is an ever-expanding multimillion-pound industry and there is more work to be done to ensure that it operates safely. In recent years, there has been a huge rise in the number of people seeking botox and fillers, which has led to an equally large rise in the number of people offering such treatment. The physical and psychological implications of cosmetic procedures are not to be underestimated and need careful consideration. The Bill rightly focuses on protecting young people from receiving botox and fillers until they are able to fully weigh those implications, and I support those aims.

The growth of the cosmetics industry is well documented, and we have seen a fundamental shift in attitudes to cosmetic interventions. It is important to acknowledge the economic and wellbeing contributions of the broader beauty and aesthetics industry. The value of the non-surgical cosmetic interventions market is predicted to rise to over £3.6 billion in the UK by 2021. People have the right to choose what to do to their own bodies, but it is vital that the regulatory framework around the cosmetics industry enables consumers, particularly vulnerable consumers, to make an informed and safe choice.

As my hon. Friend set out, children are currently able to access invasive cosmetic procedures on the commercial market without any requirement for a medical or psychological assessment. Understandably, that has come as something of a surprise to many Members who recognise that they perhaps assumed it was illegal already. I think that my hon. Friends the Members for Wantage (David Johnston), for Newbury (Laura Farris) and for Hyndburn (Sara Britcliffe) alluded to that. There are many reputable and experienced practitioners working in the sector, and this is not an attack on them, but that is by no means universally the case.

It is vital that young people are protected from practitioners who provide botox or fillers for a young person where there is no clinical need on purely aesthetic grounds. We are in danger of mistakenly thinking that having a cosmetic procedure is as straightforward as going to the hairdressers, whereas in reality, as we have heard today, the risks associated with such procedures going wrong are serious and long lasting.

Those risks were set out by my hon. Friend the Member for Sevenoaks and by my hon. Friend the Member for Bosworth (Dr Evans), my constituency neighbour, drawing on his extensive medical experience. My Department has been working to identify where improvements could be made and regulations strengthened to ensure the safety of the most vulnerable consumers. My hon. Friend’s Bill has identified an important area where the safeguards can and should be improved now. My Department is also considering whether further protections should be put in place.

I will make a couple of further points, Madam Deputy Speaker, before drawing my remarks to a close. This is not about making judgments. Young people, as we have heard, are bombarded every day with filtered selfies on social media, influencers and celebrities selling a glamorous lifestyle, which, they suggest, depends on the way someone looks. It is a dangerous and misleading prospectus.

We have heard from many Members today. My hon. Friend the Member for Stourbridge (Suzanne Webb) made her point very powerfully. It is always a pleasure to hear from the hon. Member for West Ham (Ms Brown), who rightly made a typically powerful intervention. She talked about the need for positivity and recognising that everyone is beautiful as they are and the importance of that attitude. The pressure on young people around body image is immense. That is something I saw in my work on eating disorders before becoming a Minister, working with the amazing charity Beat, to which I pay tribute.

The increased accessibility and affordability of cosmetic treatments, alongside that pressure on young people to look a certain way, has perhaps led to a sense of the normalisation of procedures. Our role in government is to support young people in making safe and informed choices and, where necessary, to protect them from the potential harm that procedures can do to their health. We currently place the responsibility to make a considered decision about something seemingly commonplace, but which could have serious consequences for their health, on very young shoulders at a time of physical and emotional development. There are already statutory age restrictions in place for tattooing, teeth whitening and sunbed use, and it makes little sense that there are no similar protections for invasive injectable cosmetic procedures. Alongside the Bill, my Department is exploring a range of options for increased oversight of practitioners, including a system of registration or licensing.

My hon. Friend the Member for Sevenoaks, as I alluded to earlier, highlighted the potential health risks of the procedures covered by the Bill. I will not repeat them, but it is safe to say that I agree with her assessment of which products should be covered by age restrictions. The proposals in the Bill will ensure that the procedures for under-18s are placed firmly within a clinical framework. They permit the procedures to continue under the directions of a doctor and to be administered within a regulated environment for medical purposes.

This Bill is the right thing to do. It represents an important and real step forward, and once again, I congratulate my hon. Friend the Member for Sevenoaks on her important and impressive work and offer the Government’s full support to the Bill.

Care Quality Commission: Deaths in Mental Health Facilities

Edward Argar Excerpts

Friday 16th October 2020 Commons Chamber

[The Minister for Health (Edward Argar)]

I congratulate my hon. Friend the Member for South Suffolk (James Cartlidge) on securing this important debate and his dedication in representing his constituents. He is an old friend of mine and I know how committed he is to his constituents’ interests. Having spoken to him about this particular case, I know how much it matters to him. I was very sorry to hear about the tragic circumstances of this case.

I wish to put on record, at her request, the fact that the Minister for Patient Safety, Mental Health and Suicide Prevention would dearly love to have been in the Chamber today, given how closely she has been involved with this case and situation. However, as a contact of a recent positive covid case, she is doing the right thing, as always, and staying away. I know that she is watching this debate as we speak and that she will continue to keep very much in touch with developments. I am sure she will speak to my hon. Friend the Member for South Suffolk very soon.

I thank my hon. Friend for raising the concerns about the tragic circumstances around the care of his constituent, Richard Wade, at the Linden Centre, and the CQC’s role in investigating the events. As my hon. Friend set out, in May 2015, Richard tragically took his own life while under the care of the Linden Centre, a mental health facility in the Essex Partnership University NHS Foundation Trust. I put on record my heartfelt sympathies for and condolences to Richard’s family. I understand the devastating impact this must have had on their lives. The passage of time will do nothing to dim that, so I wanted to put that on the record.

As a Minister in the Department of Health and Social Care, I am fully committed to ensuring that we provide the highest standards of quality and safe services to patients, and that when there are failures in the delivery of those standards, we are transparent about how we are learning lessons. My hon. Friend raised important issues about the failings of the CQC in responding to the concerns of Mr Wade’s family following his death, and I have noted the CQC’s review of its handling of these matters. The CQC states that it decided not to use criminal enforcement powers to prosecute the trust—it states that this decision was taken after liaison with the Health and Safety Executive and Essex police—and instead to use civil enforcement powers against the trust after Mr Wade’s death. The CQC further states that there was, in its view, insufficient evidence to proceed to criminal enforcement as, according to the CQC, the evidence indicated that breaches were committed by a series of individuals whose actions lay outside the CQC’s prosecution powers. However, my hon. Friend has clearly set out his views on that and on the CQC’s actions. The CQC has unreservedly apologised to Mr Wade’s family for its handling of this case.

As my hon. Friend set out, the CQC review findings identified areas for improvement and organisational learning. The CQC has committed to internal learning for staff and to support providers to recognise ligature risks and improve safety for people who use mental health services. The regulator is providing mandatory training across all inspection teams on decision making and has strengthened its enforcement training for new inspectors. Importantly, the CQC works closely with families and ensures that their involvement and feedback is considered as an integral part of what the regulator does.

On the wider health system and learnings, last year the CQC wrote to all NHS providers of mental health services regarding concerns about the quality and safety of care provided on mental health wards. While progress has been made, there is still significant variation across the country, with a lack of improvement in some mental health settings. In July this year, the CQC wrote to all NHS providers of mental health services, highlighting that it will be looking at this in inspections of wards. Where insufficient improvements have been made, the CQC will take enforcement action.

In 2018, we launched a zero-suicide ambition for mental health in-patients, which means that every mental health trust now has a zero-suicide ambition plan in place. Those trusts will be supported by a new mental health safety improvement programme, which we committed to in the NHS long-term plan.

As my hon. Friend will be aware, the Parliamentary and Health Service Ombudsman laid a report before Parliament in June 2019 on a series of significant failings in the care and treatment of another two vulnerable young men who died shortly after being admitted to the Linden Centre: Matthew Leahy and Mr R. My thoughts are with the families of all those patients who died at the former North Essex Partnership University NHS Foundation Trust, and we are committed to learning lessons from those tragic events.

As my hon. Friend said, the Minister for Patient Safety, Mental Health and Suicide Prevention gave evidence to the Public Administration and Constitutional Affairs Committee last year. The Committee looked into missed opportunities and the recommendations made by the PHSO, and my Department is considering its response to the Committee’s report, which it looks forward to publishing in due course.

As you alluded to, Mr Deputy Speaker, the Health and Safety Executive has investigated the trust, and as a result of that investigation, the Health and Safety Executive has brought a prosecution against the Essex Partnership University NHS Foundation Trust. As Members will understand—and in line with your advice, Mr Deputy Speaker, and that of the Clerks—I am unable to go into any further details on the HSE investigation. However, it has advised that the first hearing in that case will take place in Chelmsford in November. I will say no more on the case than that, in line with your guidance, Mr Deputy Speaker. It is never acceptable for patients to be exposed to avoidable risks. When things do go wrong, clinicians need to be open, honest and able to learn from their mistakes.

I turn to one of the key points that my hon. Friend raised. I am very much aware, as is my hon. Friend the Member for Mid Bedfordshire, of the petition from families of patients who have died while under the care of NHS services in the Essex area, calling for a public inquiry into the deaths. I completely understand that they have concerns that they want to have heard in public. They want answers, and they want to know what happened. My hon. Friend the Member for Mid Bedfordshire has given careful consideration to the failures in care at the former North Essex Partnership University NHS Foundation Trust. On her behalf, I am announcing today that she has set out her intention to commission an independent review into the serious questions raised by a series of tragic deaths of patients at the Linden Centre between 2008 and 2015.

[James Cartlidge]

That will be incredibly welcome for all the families connected. Can the Minister confirm that it will include the case of Richard Wade? Does he appreciate that many other Members—particularly those representing Essex constituencies, and many of whom are Ministers and therefore cannot contribute—will be incredibly pleased to hear this announcement? Frankly, none of us expected it, even though we have waited for it for so long.

[Edward Argar]

I am grateful to my hon. Friend. Although the formal terms of reference of the independent review have yet to be fully agreed, the conditions relating to Mr Wade’s death and the date certainly appear pertinent to this review and are likely to be considered as part of it. I will turn to the details in just a second.

This review will build on the recommendations made in the 2019 Parliamentary and Health Service Ombudsman’s “Missed Opportunities” report. I emphasise again, because I know that my hon. Friend has argued for this powerfully, that it will be independent. He rightly alluded to the fact that, although he is raising Mr Wade’s case today, there is a broader context, and there are other hon. and right hon. Members who have constituents who have been in a similar position and families who have approached them about this. I know that they will want to be involved as well.

[James Cartlidge]

The Minister will appreciate that this is very significant news for many constituents because of the trauma they have experienced. He is right that the key word he has used is “independent”. Will he confirm that that means, basically, that what those constituents have been asking for will be granted, because it is the best chance they will have to learn the truth of what happened?

[Edward Argar]

I am grateful to my hon. Friend for his intervention. I am just coming on to the process that will be set in train now. I emphasise that although, for the reasons I set out, it is me announcing this to the House, the work has been done by my hon. Friend the Member for Mid Bedfordshire. I want it to be recognised just how much work she has put into this issue.

We have decided to start the process now, so that the lessons learned can benefit care across the wider NHS as quickly as possible. We will work with the HSE to ensure that the review does not in any way prejudice the legal action that is under way.

Turning to the specific issues that my hon. Friend raised, the Minister for Patient Safety, Mental Health and Suicide Prevention will also be seeking as swiftly as possible a meeting with the families affected by these events, as well as with my hon. Friend and other hon. Members who are involved with this issue, to understand what they would wish to see from this process as the terms of reference and scope are agreed. The Minister is very keen to fully involve them in understanding the scope and terms of reference that need to be set and how we can seek through this process to bring them at least some degree of resolution. She will provide further details on that in due course.

[James Cartlidge]

The Minister is right to stress the work of our hon. Friend the Minister for Patient Safety, Mental Health and Suicide Prevention, who cares passionately about this. I did say this in my earlier remarks, but I must stress that I know that when she met my constituents—the parents of Richard Wade—it cut to her heart. She has shown huge compassion, which is what has driven this. It is thanks to that that my hon. Friend has announced the news he has today.

[Edward Argar]

My hon. Friend is absolutely right, and I will turn briefly to that in a second. I hope that this announcement today to commission an independent review into issues at the former North Essex partnership trust shows the strength of our commitment and my hon. Friend’s commitment in addressing the concerns he and his constituents have raised and in listening to and working with the families involved in these tragedies. We are committed to learning lessons at a national level to improve services across the whole mental health system, so that no other family experiences the same devastating loss as Richard’s family and the families of other patients who died at the former North Essex partnership trust.

In the few minutes remaining, let me say that my hon. Friend is absolutely right in what he says: my hon. Friend the Member for Mid Bedfordshire brings compassion, decency and determination to her dealings not just on this issue, but across the field of suicide prevention, mental health and patient safety. She is absolutely passionate about it. She has not only a background in medical services, but a genuine passion. It is her energy that is driving this forward and I have to say that it is a privilege to be a colleague of hers and to work alongside her in the role that I hold in the Department.

I conclude by saying once again that, of course, my thoughts and those of colleagues in this House will remain very much with Richard Wade’s family and all the families who have lost loved ones in these circumstances.

Question put and agreed to.

Public Health: Coronavirus Regulations

Edward Argar Excerpts

Tuesday 13th October 2020 Commons Chamber

[The Minister for Health (Edward Argar)]

As hon. Members will see, I have less than six minutes to respond. I regret that I may slightly disappoint the House in that—untypically for me—I will not be able to take interventions, having agreed with the Chair to enable the maximum number of Back-Bench contributions.

We have heard many different views and perspectives today, and although I may not personally fully share all of them, each represents an important and sincerely held point of view. Whatever the differences of approach among hon. Members, it is clear that all Members passionately share the common objectives of protecting lives and livelihoods. No one should doubt the underlying unity of purpose in this House.

As the Secretary of State set out, we have seen rapidly rising levels of transmission and infection, followed—with a time lag—by rising hospitalisations, particularly in the north-east and the north-west, and, sadly, increasing levels of deaths. I think it was my hon. Friend the Member for Hyndburn (Sara Britcliffe) who pointed out that this disease is sadly now moving from younger people into older, more vulnerable age groups. We therefore need to take further measures to protect the public and the NHS—as we have done throughout the pandemic—as we enter winter.

At the same time, we seek to ensure that individuals and businesses are not subject to restrictions that are disproportionate to the risk in their area or to the risk that this disease poses. We need to continue to suppress infection rates and transmission. This is not just about protecting health; it is also about protecting our economy. As hon. and right hon. Members have said, regrettably there are no easy choices here. That is why the Government are recognising reasonable calls for a simplified and clearer set of regulations, by putting in place a simplified, tiered framework so that individuals and businesses can clearly understand the rules in their local area, the restrictions in place and what they will need to do to comply with them. This helps to build on the consent and compliance that many colleagues have mentioned that comes with taking people with us and clarity of messaging.

The Government are acutely sensitive to the impact that these restrictions will have on local areas, and hon. Members have spoken passionately on behalf of their constituencies today, including a large number who have made points about the 10 pm curfew, as the House and others will have heard. We have worked and continue to work closely with local leaders to seek a consensus on the actions that we are taking at each level. In the time preceding these announcements, we increased engagement with local authorities at official level, and had meetings with local leaders and directors of public health. Their valuable insights have helped to shape the new system set out in three of these sets of regulations today. I have to say that I know of no Minister who has done more to engage directly with colleagues, councils and communities than my right hon. Friend the Secretary of State.

Local authorities and local leaders will be involved in any further actions and decisions about what level each area falls into. Having previously spent almost 10 years as a local councillor, I pay tribute to the dedication of council officers and councillors. I am clear about their vital role, working in partnership as part of a national approach. We recognise that there are elements of the restrictions that are difficult for individuals and businesses. I pay tribute to the British people and recognise the huge sacrifices that they have already made. That is why it is right that my right hon. Friend the Chancellor has introduced further support measures, alongside the very extensive support package that he set out to the House earlier in the year.

The measures in these regulations are reasonable and proportionate, given the increased rates of transmission that we are seeing and in the context of our clear commitment to keep education settings open, and businesses open as much as possible. I reassure the House that throughout, as evidence and the science—I use that term in the plural—develop and evolve all the time, we continue to keep that under review, and I approach emerging scientific evidence with an open mind.

I urge hon. Members to join me today in supporting these regulations relating to the covid alert levels and enforcement action, tracing and businesses, recognising the very challenging infection point that this country sits at today, with rising infection and hospitalisation rates. The fight against this virus is certainly not over and we must all continue to play our part in tackling it. These measures seek to do that in a proportionate and clearly understandable way. This House and its collective wisdom are vital to getting it right, and I hope that this evening the House will demonstrate that wisdom and vote for these measures.

Queen Mary’s Hospital: Urgent Care Services

Edward Argar Excerpts

Monday 12th October 2020 Commons Chamber

[The Minister for Health (Edward Argar)]

I congratulate the hon. Member for Putney (Fleur Anderson) on securing this debate on an issue that is important to her constituents and more widely across south London and on her typically reasonable and measured tone in putting her constituents’ case so clearly and firmly. As she did, I pay tribute to the staff at Queen Mary’s, St George’s University Hospitals NHS Foundation Trust and across our entire NHS for the amazing work they do day in, day out, but particularly during this pandemic. Thanks to their dedication and their response to the public health measures and restrictions, which have been difficult for many people, the NHS was not overwhelmed during the first covid wave, and we have put in place measures to prevent that from happening in a second wave.

As the hon. Lady said, coronavirus has brought challenges and forced us all to do things differently to manage the pandemic, protect the NHS and save lives. There is no doubt that it has led to rapid changes in the way that health and care services are delivered, as providers have refocused their efforts on tackling the pandemic, but also on providing services in a safe way for other service users. But it is important that these changes are temporary and that the NHS is working to reopen services as soon as it is safe to do so. She said that she hopes her constituents in Roehampton will not be overlooked in this place and I suspect that, as long as she is a Member of this House, they certainly will not be.

The hon. Lady was right to highlight the importance of local services so local people can access services easily, without transport or other challenges. It is regrettable that the urgent treatment centre at Queen Mary’s Hospital remains closed. I know that that decision was not taken lightly by the trust. It was taken on clinical advice by the trust to protect the safety of patients, staff and the public. I believe it has been closed since 30 March this year. As she succinctly put it, the issue is due to the requirements of social distancing and the critical importance of infection prevention and control. Therefore, given the configuration of the centre, and its walk-in aspect, it could not operate as it did before the pandemic. It is not able easily to segregate patients with respiratory problems, treat them with dedicated staff, or maintain the necessary distancing.

I am conscious that the trust has yet to set out a firm commitment to a reopening date, but I join the hon. Lady in saying that I hope it will set out its future plans as soon as possible. I am conscious that she has met the trust’s chief executive, Jacqueline Totterdell, to discuss these issues and plans for the reopening of the urgent treatment centre. Although that reopening date is still to be confirmed, I understand that the trust and local commissioners are undertaking work to agree a new covid-secure model of care before reopening, which is the right approach.

My offer to the hon. Lady is twofold and I hope it will be helpful. First, I am happy to raise the issue directly with the chief executive of the trust to consider both timescales and a date for the reopening. Secondly, if she feels it would be useful, I am happy to ask my office to get in touch with her and arrange to meet her in a slightly less formal environment than this Chamber, to discuss in more detail the urgent treatment centre and the pharmacy, which I will come to in a moment.

The hon. Lady highlighted not only the urgent treatment centre but its role in helping early diagnosis and treatment of cancers. I completely understand and recognise her concerns about the impact of the pandemic on cancer services and the importance of ensuring that cancers do not go undiagnosed. The NHS is working to restore the full operation of all cancer services, with local delivery plans being delivered by cancer alliances. Systems will be working with GPs and the public locally to increase the number of people coming forward and being referred with suspected cancer to at least pre-pandemic levels—I will come on to the performance of her local trust in a moment.

To support that, systems will help to ensure sufficient diagnostic capacity in covid-19-secure environments, through the use of independent sector facilities and the development of community diagnostic hubs and a rapid diagnostic centre. The hon. Lady is right to highlight that diagnostic capability is a considerable challenge, not least because, to put it perhaps a little bluntly, many diagnostic tests are very close and personal, and the equipment used is intimate in terms of looking inside the human body. The cleaning and infection control measures that are necessary between each patient make it challenging to see as many patients as would have been the case before the pandemic.

The cancer recovery taskforce met in September to review the status of cancer services against recovery metrics and a national recovery plan is being developed for publication shortly. In respect of the hon. Lady’s particular trust—I am afraid that I have only the figures for the overall St George’s trust, which I hope will none the less be useful—referrals in August for cancer treatment, as I understand it, were twice as high as they were in April, so a lot of work is being done to pick that up. On the basis of the latest figures that I have, which I think are for August, the trust saw 87.8% of people within the two-week target and 94.5% of those referred for treatment received that treatment within 31 days. So I put it on the record that, in very difficult circumstances, her trust is doing a very good job to bring those services back into operation.

It is important that we continue to advise people to contact their GP or to seek the help they need about a symptom that could be cancer or that could represent a risk. The hon. Lady is right that it is important that, when people do need help, they are able to access that GP service and get the advice that they need.

I turn to cancer screening, which I know is something that, although the hon. Lady did not mention it specifically, is relevant to that diagnostic capability and capacity. In some areas, providers of screening services did reschedule invitations or appointments to a later date, again to address infection control risks, but cancer screening services as well are now being restored as swiftly as it is safe to do so. I spoke to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who has responsibility for, among other things, breast cancer screening services, and I think that something like—I may not have the exact figure—80% to 85% of the backlog has now been caught up in recent months. It is important that we sustain that improvement and that the hon. Lady’s constituents see that improvement.

As the country continues to deal with covid, I want to reassure the hon. Lady that the Government are committed to providing and ensuring access to high-quality care that meets the needs of people across England, irrespective of where they live. She is absolutely right that it is vital that her constituents are able to access and get that local medical help when they need it, and that includes the pharmacy that she mentioned. The hospital pharmacy is absolutely vital for people being able to have timely access to the medicines they need and being able to get them on site. Although people using it will have been treated and advised in hospital, they can none the less get very helpful advice from the pharmacy as well, so I share her view about the importance of that. As I have said, I include that in my offer to her—to discuss that with her and with the chief executive. I will endeavour to do that later this week, but I am afraid that, given that I think I am taking through seven statutory instruments in here tomorrow, it may be towards the back end of the week that I am able to do that. However, I will endeavour to do so.

The Government remain committed more broadly to restoring urgent non-covid services in a safe way and supporting NHS capacity to protect against the risk of a further surge in cases and, of course, the increased pressures—the hon. Lady alluded to that as the context for this—on the system during the winter. I reiterate my thanks to our NHS staff, not only for what they have done, but for what I suspect they are going to have to do in the coming months.

The hon. Lady will be aware that we have announced considerable further investment in the NHS: an extra £3 billion in July to help support the NHS, and £450 million of capital funding for urgent and emergency care services and expansions. I recognise that this is not going to her own hospital, but I would just highlight that £2.5 million is going to St George’s. Quite rightly, she will champion Roehampton, but I am sure she will welcome that more broadly as well. However, I recognise her concerns about Roehampton, which is why I am happy to meet her.

I simply reiterate that I share the hon. Lady’s view that, where services for perfectly good and legitimate clinical reasons have been temporarily closed or altered, it is extremely important that they are reopened as soon as trusts are able to do so and, where in the future any changes are proposed, that they are subject to the usual full public consultation, engagement and consideration. I do not want to see temporary measures becoming permanent by default, and she can read that as perhaps an expression of my view on what is happening in Roehampton.

As the hon. Lady knows, the next step is for the local commissioners, together with the trust, to agree the new covid-secure model of care so that the centre can reopen in a way that is safe for patients, staff and the public. I will ensure that I remind them of the need to keep her fully updated, although I suspect they will not need that, because I suspect they know that she has an extremely high level of interest in this on behalf of her constituents.

I hope that I have been able to offer the hon. Lady some reassurances today. I thank her for securing the debate, and I very much look forward to meeting her. I am afraid that, at the moment, it has to be an offer of a meeting either by Zoom or in this place, but I hope that at some point, when we are able to do so safely and without hindering the work of those working in the hospital, I may even be able to visit her hospital with her in the near future.

Question put and agreed to.

Draft European Qualifications (Health and Social Care Professions) (EFTA States) (Amendment Etc.) (EU Exit) Regulations 2020

Edward Argar Excerpts

Wednesday 7th October 2020 General Committees

[The Minister for Health (Edward Argar)]

I beg to move,

That the Committee has considered the draft European Qualifications (Health and Social Care Professions) (EFTA States) (Amendment Etc.) (EU Exit) Regulations 2020.

It is pleasure to serve under your chairmanship, Ms Fovargue. I suspect that this will be one of a run of such delegated legislation committees that we will consider in the coming weeks.

The regulations relate to the recognition of professional healthcare qualifications in the UK, and social work qualifications in England. They are part of the Government’s preparations for the end of the transition period.

As members of the Committee will know, the Government have signed agreements with three European Economic Area European Free Trade Association states and Switzerland in relation to the UK’s withdrawal from the EU at the end of the transition period. The agreements include provisions that protect the rights of EEA EFTA state professionals with qualifications covered by the directive, and Swiss nationals living and working in the UK, and vice versa.

On 14 September 2020, the House considered legislation brought forward by the Department for Business, Energy and Industrial Strategy that set out arrangements for the recognition of professional qualifications from Switzerland and the EEA EFTA states. The regulations before us cover a similar area. They implement the Swiss citizens’ rights agreement and the EEA EFTA separation agreement in relation to the recognition of professional qualifications, or RPQ, as I will now to refer to it for the sake of brevity, for healthcare in the UK and social work in England. They also make some minor changes to ensure that recognition arrangements for EU health and social work qualifications continue to function effectively after the transition period.

I will remind the Committee briefly of the background to RPQ. The current system for RPQ is derived from EU law. It allows UK professionals to have their qualifications recognised in the EEA and Switzerland, and vice versa, with minimal barriers. There are seven professions where standards are harmonised under the relevant directive. That means that qualifications must comply with minimum agreed standards and, where these are met, that such qualifications are automatically recognised by regulators throughout the EU and, by virtue of additional treaties, the EEA EFTA states and Switzerland. Five of those harmonised professions are health professions: doctors, nurses, midwives, pharmacists and dentists.

The recognition arrangements under the directive have supported the movement of European health and care professionals to the UK. At the end of the transition period, the EU directive will cease to apply to the UK and the mutual recognition of professional qualifications will end. Let me be clear that this will allow for some improvements on the current system.

Last year, in preparation for the UK leaving the EU, Parliament passed regulations to amend the domestic law that implements the current EU system for RPQ, including regulations in relation to recognition arrangements for health and care professional qualifications, namely SI 2019/593. I believe that when that measure was considered in Committee by my predecessor but one, the shadow Minister, the hon. Member for Ellesmere Port and Neston, was the Opposition spokesman.

Today’s regulations, which will come into force at the end of the transition period, include provisions that ensure that healthcare qualifications that are currently recognised automatically continue to be so, for up to two years after exit day; protect previous recognition decisions; and allow applications for recognition submitted before exit day to be concluded after exit day on the basis that they are already in train. They also remove the provision for healthcare professionals to deliver temporary and occasional services in the UK once such current registrations come to an end.

During the period of continued automatic recognition, UK regulators of healthcare professionals will further refine arrangements for registering all international health and care professionals, including those who hold European qualifications.

Since the passing of the EU exit regulations, the Government have secured further agreements with Switzerland—the Swiss citizens’ rights agreement—and the EEA EFTA states—the EEA EFTA separation agreement. Those agreements go further than the arrangements set out in the regulations that were passed last year. The regulations before the Committee today amend the previous statutory instrument in order to implement the improved terms of the Swiss and EFTA agreements. I will briefly set out the main changes.

First, they allow Swiss nationals—and their spouses and dependants—who hold qualifications that are currently recognised automatically to have those qualifications recognised on an automatic basis where the application is made for up to four years after the end of the transition period, rather than the current two in the original SI. Secondly, they allow Swiss healthcare professionals and their dependants to continue to provide temporary and occasional services, in accordance with their contract, for up to five years after the end of the transition period, with a limit of 90 days’ service per calendar year.

In addition, for both EEA EFTA state EU-qualified professionals and Swiss nationals, the regulations will require that UK regulators co-operate with their EEA EFTA state and Swiss counterparts to facilitate the smooth completion of applications ongoing at the end of the transition period; and ensure that individuals whose professional qualifications are recognised are treated on the same basis as UK nationals. It is important to emphasise that the arrangements under this new SI will be reciprocated by the EEA EFTA states and Switzerland respectively.

I would remind the Committee that these regulations only concern the healthcare professions across the UK and social workers in England. All other regulated professions are covered by separate but similar legislation made by the different and responsible Government Departments and, where appropriate, the devolved Administrations.

For completeness, the regulations also make minor amendments to ensure that the frameworks for RPQ will function as intended after the transition period: they will ensure that GP qualifications obtained before the reference date specified in the MRPQ—mutual recognition of professional qualifications—directive are recognised in the same way as specialist medical qualifications obtained before that date, and are not eligible for automatic recognition.

On consultation, it is important to note that UK regulators of healthcare professions have been consulted on an informal basis throughout the development of RPQ EU exit legislation, including these regulations.

To conclude, the regulations are a small but necessary step forward to implement the Swiss citizens’ rights agreement and the EEA EFTA separation agreement, in respect of the recognition of professional qualifications. Those agreements were signed after the making of the previous EU exit legislation on this matter, hence this statutory instrument. The regulations enable health and social care professionals and businesses to better prepare for the end of the transition period, and represent a further degree of continuity and co-operation.

I commend the regulations to the Committee.

--- Later in debate ---

[Edward Argar]

It is, as always, a pleasure to serve opposite the shadow Minister, who always approaches these debates in a spirit of common sense and constructive challenge; so I am grateful to him, although I am not quite sure what I should read into his reference to me as the “current” Minister, and whether he knows something that I do not. Maybe it is a reflection on the number of my predecessors that he has seen standing in this place opposite him during his tenure.

[Justin Madders]

I meant that the Minister is a very talented individual, and no doubt will be elevated to higher service in the not too distant future.

[Edward Argar]

The hon. Gentleman is very kind, but I am not sure whether his comments will help or hinder that cause—as the Whip takes note.

The hon. Gentleman is right that the statutory instrument is dry and technical but important. It represents our taking—in co-operation with the Opposition, for whose support we are grateful—a prudent series of steps to help address concerns about what will happen for those professionals from this country who work in Switzerland and EFTA and, likewise, the reciprocal rights.

The hon. Gentleman asked several questions; I will try to respond to them all. He mentioned the timing. Everyone would wish that we were able to bring measures such as this forward as soon as possible, to give those affected as much time as possible to prepare, but in the nature of things, with all the multiple strands being negotiated, these matters came to be negotiated after the 2019 SI and we have brought them forward as soon as we could following the conclusion of those treaties.

The hon. Gentleman reflected a great deal on workforce numbers, and the impact on the workforce more broadly of the decision in the referendum to leave the EU and what steps we were taking to ensure that the NHS and social care continued to have the numbers they needed to provide the extraordinary service that all those professionals perform for people. He was right to highlight a small drop in the number of registered nurses from EU and EFTA countries—although I would point out that the number of doctors from those countries has remained broadly constant since 2016. Actually, that small reduction has been more than offset by the significant increase in the number of nurses coming from outside EU and EFTA states—an increase of around 29,500. In reply to his perfectly reasonable question on what guarantees, what reassurances, I can offer about the continued supply of nurses, doctors and social care workers to our caring services, I remind him that the Government are well on target to meet their pledge of 50,000 more nurses in the NHS in the course of this Parliament. I think—I may be slightly out—we are well over 13,000 up. While I note his point, if we look at the overall nursing, social care and medical workforce in the round, any slight reduction from EU sources has been more than offset by increases from elsewhere.

The hon. Gentleman asked whether there were any other costs or barriers or assessments thereof for Swiss or EFTA nationals. None has been drawn to our attention. The regulations address one of the key things that was a risk and a barrier, but if he is aware of any specific issues, I am happy for him to raise them with me.

The hon. Gentleman’s final point was on EU enforceable rights. I will endeavour to give him clarity. This answer is slightly technical, so if he feels his question is not answered fully, I am happy for him to write to me following the Committee and I will try to provide more detail. The regulations apply to both Swiss nationals with qualifying professional qualifications and to a national of a third country who has an enforceable EU right through their relationship with a Swiss national. That means, in effect, that spouses and dependants of Swiss nationals must have their health and care qualifications assessed in the same way in which a Swiss national would. There is a single exception relating to EU nationals who are spouses or dependants of particular groups. I will write to him with some of the technical points around that if he wishes, because I think he seeks a greater degree of clarity.

The hon. Gentleman also raised more broadly the long-term arrangements for the EU workforce in our health and social care sector. I would have been surprised had he not done so. My answer, which will not surprise him—I suspect it is the same one he has received from many of my predecessors—is that these are matters outwith the treaty and outwith Switzerland and EFTA. They are matters for the ongoing negotiations with the EU that we are engaging in continuously and constructively. I do not want to prejudge the outcome of those negotiations, but I hope that both sides can find a way forward to an agreement in the coming weeks.

Question put and agreed to.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 6th October 2020 Commons Chamber

[The Minister for Health (Edward Argar)]

It is vital that non-covid treatments are restored as quickly and safely as possible. That is what the NHS is doing. It is working to have them restored, by October, to around 90% of last year’s levels.

[Dr Johnson]

Thankfully, children are relatively robust in the face of coronavirus. However, children’s services, like other hospital services, were understandably reduced during the pandemic. What is my hon. Friend doing to ensure that paediatric services are now 100% up and running and will not be affected by a future wave of the pandemic? What is he doing to support NHS trusts in dealing with the backlog of appointments delayed by the coronavirus?

[Edward Argar]

I pay tribute to my hon. Friend for her service to her constituents both as their MP and as a paediatric clinician. She is right to raise this important issue. Restoration guidance has already been published by NHS England and NHS Improvement, setting out a framework to fully restore services in this area, which I agree is vital. I would be very happy to meet her to discuss this further.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

What recent discussions he has had with the Secretary of State for Education on allocating additional resources for mental health support in schools.

Shotley Bridge Community Hospital

Edward Argar Excerpts

Tuesday 6th October 2020 Commons Chamber

[The Minister for Health (Edward Argar)]

I congratulate my hon. Friend the Member for North West Durham (Mr Holden) on securing a debate on this important issue. His timeliness in doing so is, as ever, perfect, as was his impressive history lesson and his relating that history of the hospital to the present.

The future of Shotley Bridge Hospital is, as my hon. Friend said, an issue that this House has become familiar with in recent months, through his regularly raising it in the Chamber on behalf of his constituents and his local campaigning on it—something well attested to on his website and well reported in recent weeks in both the Chronicle and Consett Magazine. As he said, he kindly invited me to visit his constituency to see Shotley Bridge Hospital for myself. However, I cannot blame him for upgrading last month and securing a visit instead from my right hon. Friend the Secretary of State, although I hope I might yet enjoy North West Durham and County Durham hospitality and a welcome if my invitation still stands.

[Mr Holden]

The invitation definitely still stands, and the Minister is welcome whenever he would like to visit.

[Edward Argar]

I am grateful to my hon. Friend. Having secured that re-invitation, I look forward to that. I would like to put on record, as he did in his speech, my thanks to all who work in Shotley Bridge Hospital and more broadly in the County Durham and Darlington NHS Foundation Trust for the amazing work they have done for his constituents and more broadly during the pandemic, and indeed for the care that they all provide day in, day out, all year round, regardless of the public health context.

Shotley Bridge Hospital is, as my hon. Friend said, a key part of the local healthcare landscape in the services it provides, but he has effectively made the case that it has the potential to do even more. I know that the sustainability and transformation plan set out the long-term approach to the strategic delivery of health services in these areas, but the CCG and the trust itself have undertaken considerable work on this as well. As I say, the staff are doing an amazing job, but the current hospital faces challenges. In the last financial year—I am sure my hon. Friend will correct me if I get this wrong—it had total running costs of around £1.7 million and £570,000 annual maintenance costs simply to keep the buildings working. These annual costs are a challenge, but so too is the nature of the physical space, including its usage of the current site and the access to it.

The case for, and commitment to, the hospital is clear. As I understand it, there has already been a consultation on elements of this matter in spring 2019. I was therefore extremely pleased that my hon. Friend’s campaigning had paid off and that a new hospital for Shotley Bridge was included in the list relating to the £3.7 billion investment in 40 new hospitals to be built, which my right hon. Friend the Prime Minister announced late last week. This is a reflection of a Government delivering on their pledge to build 40 new hospitals, and it is a fantastic example of this Government delivering on their commitment to levelling up.

This new hospital for the people of North West Durham, and indeed more broadly, reflects the healthcare needs of the local population and the local context. As I understand it, the CCG and the trust are continuing to work out the details and consult further, and I encourage my hon. Friend to continue to work closely with them in that endeavour, as I believe he is doing. Let there be no doubt about what he has achieved with this announcement, less than a year after being elected and after a decade of this matter barely being raised in this House. I make an honourable exception to that, because I know that the right hon. Member for North Durham (Mr Jones) has continued to raise it, and that he has worked with my hon. Friend. However, I know that it is my hon. Friend’s passion, as the Member for North-West Durham, that has delivered this result.

[Mr Kevan Jones]

I congratulate the hon. Member for North West Durham (Mr Holden) on his efforts, but a lot of work has been done on this over many years, including by many councillors. I know that the hon. Gentleman mentioned councillors, but he excluded the Labour councillors and Durham County Council, who have been working with the CCG and others to deliver this. It is something that will benefit the entire area, and yes, I congratulate him, but the important thing is that a lot of this work was done before he even knew where Consett was.

[Edward Argar]

I suspect that my hon. Friend has long known where Consett is, and he has been campaigning hard since his election, but I shall take the right hon. Gentleman’s intervention in the spirit in which it is meant. I have alluded to his work on this, which is only right, but he is right to point out, in relation to my earlier references to the work that had been done previously during the consultation by the CCG and others, that I should also recognise the work done by councillors and other local campaigners and, indeed, by local people in that context.

The new hospital for the people of North West Durham —and the broader region, as the right hon. Gentleman rightly says—will be part of a model of care developed to reflect the healthcare needs of that local population. My hon. Friend the Member for North West Durham, in working to understand those healthcare needs and working with others, as is his way, has secured agreement for the delivery and funding of one of his key local election pledges when he stood for this House in 2019. To answer some of his questions specifically, we will fund this new hospital, and I have no intention of that being through a PFI.

My hon. Friend has been clear, and I agree with him, that this new hospital will not only contain, as he has set out, an enhanced range of services, but, crucially, those in-patient beds that he has been so very clear about. As the trust and others work through—

--- Later in debate ---

[Edward Argar]

Mr Deputy Speaker, I should have seen that coming. As a former member of the Procedure Committee, I should have remembered it would be coming. However, I will pick up where I left off.

My hon. Friend’s commitment is clear, and I agree with him that those in-patient beds are absolutely crucial. I know, initially, there was some talk or some suggestion of no in-patient beds or of a small number. He has been very clear that the number needs to be 16, and I heed what he says.

I look forward to receiving the detailed business cases in the coming months and—presuming, as my hon. Friend and other hon. Members would expect, that they meet the standards we would expect for the spending of public money and robust project delivery—to approving them and securing their approval from the Treasury. I also look forward, subject to that consent being forthcoming, to seeing construction start in 2022-23, I hope, with a swift construction so that his constituents and those of the right hon. Member for North Durham can enjoy the facilities of a new hospital as swiftly as possible.

My hon. Friend the Member for North West Durham mentioned one other point, which was about restrictions related to tackling the covid pandemic—and, indeed, their impact on the health service and the provision of normal health services—only being in place as long as they are necessary to protect public health. I entirely agree with him. None of us wishes to see them in place a day longer than they are necessary to achieve that primary purpose, but regrettably, they do remain necessary at the moment to ensure the safety of patients and others accessing those services.

The subject of this debate is the future of Shotley Bridge Hospital. Thanks to the staff at the hospital it has a bright future and thanks to the local people, local campaigners and their passion for this hospital it has a bright future, but thanks to my hon. Friend it has an incredibly bright future. He has secured that future—that brighter future—through his campaigning and his success in his campaign. His is a plan about which, if I recall correctly, according to a survey of local residents or local constituents he undertook, 92% of those responding agreed with the approach he is proposing.

This is a Government who deliver on our pledges, and my hon. Friend is a local MP who delivers on his pledges to his constituents. They are lucky to have him representing them in this place. He is a strong voice for them, and he has played a central role in delivering that brighter future for Shotley Bridge Hospital.

Question put and agreed to.