Oral Answers to Questions

Debate between Edward Argar and Debbie Abrahams

Tuesday 12th September 2023 Commons Chamber

[Edward Argar]

I crave your indulgence, Mr Speaker. May I take this opportunity to pay tribute to the hon. Member for Cardiff North (Anna McMorrin), who shadowed me for some time, and to the hon. Member for Lewisham West and Penge (Ellie Reeves), who also did so? I wish them both well, although given the latter’s election co-ordination role, hopefully not too well.

It remains our priority to deliver swifter access to justice for victims of rape. As the hon. Gentleman says, the experience of attending court is incredibly difficult for them. That is why we have committed to increasing the number of independent sexual violence advisers and independent domestic violence advisers to more than 1,000 over the next three years. In June 2022, we announced our ambitious specialist sexual violence support project in three Crown courts, aimed at improving facilities and technology.

On the hon. Gentleman’s specific question, I would urge a degree of caution on those proposals. Listing is a judicial prerogative, and it is important we retain flexibility in the use of the court estate to maximise the use of courts and judges’ time for a range of offences and to meet the needs of the courts.

[Debbie Abrahams]

The independent inquiry into child sexual abuse recognised the issues with the criminal justice system and said:

“The length of time taken to investigate and prosecute child sexual abuse cases was…a matter of significant concern. Delay within the criminal justice system can add to the harm caused by sexual abuse”.

The experience of a constituent I am helping suggests that is still the case. What mandatory training for court, judicial and other criminal justice is available to ensure that they appropriately support people who have been subject to this abuse?

[Edward Argar]

It is nice to see the hon. Lady in her place and it is always a pleasure to answer questions from her. She highlights an important issue raised by IICSA and historic and current child sexual abuse. It is worth remembering that the investigation of such crimes can be lengthy because of the complexities of the crimes and of obtaining evidence. While training for the judiciary and courts is a matter for the judiciary and the Judicial College rather than for the Government, we have been investing in training, as have police forces, across a range of specialisms, including handling child sexual abuse cases. It is important that they are handled with sensitivity and with an understanding of the impact that the trauma has had on those who are victims, and indeed also those who are witnesses. She touched on a specific case and I am happy to engage with her outwith the Chamber if that would be helpful.

Health and Care Bill

Debate between Edward Argar and Debbie Abrahams

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Edward Argar]

I will make a little progress, then I will give way to the hon. Lady, as I tend to do. She is a regular participant in health debates.

We are already committed to improving workforce planning. In July 2021, as I said, we commissioned that important work with partners to review long-term strategic trends. It is also important to note in that context that my right hon. Friend the Secretary of State announced that we are merging NHS England and Health Education England, which is a hugely important move that brings together the workforce planning and the provision of places and of new members of the workforce with the funding available for that and the understanding of what is needed in the workforce. It brings supply and demand considerations together.

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

Will the Minister give way?

[Edward Argar]

I will make a little more progress, then I will give way to the hon. Member for York Central (Rachael Maskell) and then, if I have time, I will give way to her. I want to address the points of the hon. Member for Lewisham East (Janet Daby) in good time and I am conscious that the votes took up a chunk of the time allowed for this group of amendments.

We are also committed to increasing transparency and accountability. The unamended clause already increases transparency and accountability on the roles of the various actors within the NHS workforce planning system.

[Edward Argar]

The hon. Lady will be pleased to know, or will I hope be reassured to a degree to know, that underpinning our strategy to grow the workforce—for example, the nursing workforce or other specialisms—is the fact that we have multiple strands to the strategy. Those coming from overseas who wish to work in the NHS are always going to be an important and valued part of our NHS workforce, but of course we are also committed to growing the number, for want of a better way of putting it, that we grow at home through training places and medical schools. Crucially, however, a key element here is retention of our existing staff, so that we are not simply recruiting and training lots more staff to replace those who are leaving. All of those factors are important.

[Debbie Abrahams]

Does the Minister want to comment on the fact that 100-plus organisations—and not just those 100 organisations, including the BMA, but former chief executives of NHS England—are still very concerned that the Government’s measures on workforce planning do not go far enough?

[Edward Argar]

I am grateful to the hon. Lady, and she and I have worked together on a number of issues in the past. We always engage—and the since the inception of the Bill and throughout its passage, we have engaged collaboratively—with a whole range of organisations, such as professional bodies and trade unions, including some of those she mentioned. We believe that the approach we have adopted in the commissions from the Secretary of State, coupled with the merger with Health Education England, will be a significant step forward, and we believe it is the right approach to take. I suspect that the hon. Lady may disagree, and I always respect her opinion, although I may not always agree with it.

--- Later in debate ---

[Edward Argar]

I can reassure my hon. Friend that under the changes we are putting in place through the integrated care systems, ICBs will continue to be able to commission services and to send patients to hospitals outside the ICS area. They will also be obliged to co-operate and work with other organisations in the patient’s best interests. We are setting this alongside the broader work that we are doing in the Department on the interoperability of data. I hope that that has reassured her to a degree.

We are also committed to supporting research, and I ask the House to agree to Lords amendments 6, 15, 26 and 28, which further embed research and provide increased clarity, transparency and oversight in respect of ICBs, NHS England and the Secretary of State’s research duties.

[Debbie Abrahams]

I want to ask the Minister about two matters. First, why are health inequalities not explicitly mentioned among the triple aims of the Bill? Secondly, on the membership of ICBs, I am sorry if I misheard, but I did not hear him discuss the amendment on how to avoid any conflict of interest involving private providers on those boards.

[Edward Argar]

The reason for that is that an amendment was brought forward on Report, and the matter was settled at that stage; things have not changed since. In lieu of what had been tabled, we tabled our own amendment on Report, which—even though in our view it was unnecessary—we felt further clarified how to avoid conflicts of interest. In the previous group of amendments, we tabled an amendment to extend that conflict of interest policy and approach to the sub-committees of the boards, in order to ensure that it is explicit that the policy applies to both. It is essentially the same principle, but widened out to the sub-committees to avoid them being inadvertently left out of the legislation.

[Edward Argar]

I can give my hon. Friend an assurance that we expect that to be the case. I will turn to palliative care in the context of other amendments shortly, and I might address some of his points then.

We are also committed to tackling climate change. Lords amendments 9, 18, 33 and 40 place duties on NHS trusts, foundation trusts, ICBs and NHS England to have regard to the Government’s key ambitions on climate change and the natural environment in everything they do. The amendments include a guidance-making power for NHS England that will assist in the discharge of these duties by different bodies.

There are also a number of amendments relating to how integrated care boards should operate as statutory bodies. Amendments 19 to 21 and 23 require an ICB to consider the skills, knowledge and experience it needs to discharge its functions and, where there are gaps, to consider what steps it can take to mitigate them. The amendments also require the forward plan to include detail on how the ICB intends to arrange for the provision of health services, as well as its duties under sections 14Z34 to 14Z45. The annual report must also include an explanation of how it has discharged these duties.

The hon. Member for Oldham East and Saddleworth (Debbie Abrahams) mentioned conflicts of interest. We amended the Bill in this place, and the Lords amended it further with Lords amendment 11. We understand the motivation, but the drafting does not fulfil the stated aim, which is why we tabled an alternative amendment in lieu of that amendment.

[Debbie Abrahams]

Will the Minister give way?

[Edward Argar]

I want to make a little progress. If I make good time, I may be able to give way, but I am conscious of the need to give the shadow Minister and other colleagues plenty of time to speak—about, I suspect, one aspect of this group of amendments in particular, but we will see.

We commend a number of additional amendments to the House. Lords amendments 34 to 37 limit the powers to set capital expenditure limits for NHS foundation trusts, so that they cannot apply for periods longer than a financial year. I reaffirm my commitment to ensuring that these powers on expenditure limits are used only as a last resort, as NHS England agreed with NHS Providers. I also ask the House to accept Lords amendments 50, 65, 104, 106 and 107, which are minor and technical changes required to ensure that the Bill functions as intended.

Although we have made progress on a number of amendments, we urge the House to disagree with the other place on others. First, we ask the House to disagree with amendment 90 on dispute resolution in children’s palliative care, and instead support the amendment we tabled in lieu. Our approach will require the Secretary of State to commission a full independent review of the causes of disagreements between the providers of care and persons with parental responsibility on the care of critically ill children, how these disagreements can be avoided, and how we can sensitively handle their resolution.

We also seek to reject Lords amendment 81. Although we agree on the need to make good progress on the Care Act 2014, it is not in the interests of good government to be forced to implement reform of this complexity and scale through a deadline set in primary legislation. We are getting on with implementing social care reform, and operational guidance is out for consultation. We have announced a small number of local authorities that will act as trailblazers to test the reforms from January 2023, but we must take time to engage with local authorities as they build the necessary infrastructure, and use these trials to refine delivery systems and guidance ahead of the national roll-out. We encourage the House to reject Lords amendment 81, which we believe affects the financial arrangements to be made by this House and, as such, is subject to financial privilege.

[Debbie Abrahams]

I would be grateful if the Minister answered my question about the triple aims, and the impact of not including in them an explicit reference to health inequalities. The Bill refers to health and wellbeing, but not to health inequalities. My main point is on the care cap. More than one in six of my constituents with dementia will not reach the cap, as it stands. The Lords amendments mean it would be one in five, so I would be grateful if the Minister could say exactly why he is prepared to let one in six of my constituents not reach the care cap.

[Edward Argar]

I will address the care cap, because there is a fair bit to say. I was just addressing the noble Lord Lansley’s amendment. I apologise for missing the hon. Lady’s first point. We do not think it is necessary to have health inequalities explicitly among the triple aims, as we believe that the issue runs through everything that ICBs do and everything the Bill sets out. We therefore feel that the Bill is effective, and that each ICB’s ICS will have regard to health inequalities and will see them as central to its objectives.

Before I turn to Lords amendment 80, I will briefly address Lords amendment 51, which relates to consultation with carers during hospital discharge planning. We have heard about the strength of feeling in the other place on that issue. We wholly agree that we must ensure that, where appropriate, unpaid carers are involved in planning around discharge. Although the Government appreciate the intention behind the amendment and want to address the concerns raised, we want to do so in the most effective way, and in a way that does not create unintended delays to discharge. I ask Members to support our amendment in lieu, which would achieve much of what Lords amendment 51 sought to achieve. It will introduce a new duty on trusts and foundation trusts to involve carers during adult discharge planning. Unlike schedule 3 to the Care Act 2014, this duty applies to all carers where the patient has care and support needs following discharge; and it applies to young carers as well as adults. Our amendment in lieu and the new statutory guidance will ensure that patients and carers are involved in discussions about post-discharge care as soon as they start.

Covid-19: Government’s Publication of Contracts

Debate between Edward Argar and Debbie Abrahams

Tuesday 9th March 2021 Commons Chamber

[Edward Argar]

My hon. Friend is absolutely right to highlight this amazing achievement. It reflects on the phenomenal effort of our frontline health and care workers, but also more broadly on the partnership we have seen at work in this country over the past year between the public sector, the private sector, the voluntary and charitable sector and ordinary members of the public all working together in a joint effort to beat this disease. My hon. Friend is absolutely right to highlight that.

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

As much as I have a high personal regard for the Minister, he is incorrect in his remarks. The High Court ruling last Friday made it absolutely clear that at the time of the Prime Minister’s response to hon. and right hon. Members in this House last month 100 contracts had not been published; they were outstanding. Whether intentional or not, the Prime Minister—[Inaudible]—was factually untrue; he needs to come to this place with a full apology, as warranted by the ministerial code.

[Edward Argar]

I lost a few words of the hon. Lady’s question, but I think I know what she was asking about in respect of the Prime Minister’s remarks on 22 February. May I start by saying that her kind words at the start of her contribution are reciprocated? I have known her since I came to this House and I have the highest regard for her as well; so I am grateful for her kind words.

In terms of the specifics the hon. Lady asked about in respect of the Court judgment and the Prime Minister, as I understand it on the date the Prime Minister spoke 100% of the contract awards notices—the details of the contracts are contained within them—were published, and that, I believe, is what my right hon. Friend was referring to.

Covid Contracts: Judicial Review

Debate between Edward Argar and Debbie Abrahams

Wednesday 24th February 2021 Commons Chamber

[Edward Argar]

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

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

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

[Edward Argar]

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

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

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