Commonwealth Parliamentary Association and International Committee of the Red Cross (Status) Bill

Debate between Edward Argar and Rosie Winterton

Friday 26th April 2024 Commons Chamber

[Edward Argar]

As ever, my right hon. Friend is right. Therefore, subject to the passage of this legislation and prior to those regulations being introduced, until they come into force, they do not come into force. We will work closely with those organisations so that when those regulations are laid and approved, hopefully there will be no surprises in them because they will have worked collaboratively with us to draw them up.

The arrangements will detail the day-to-day management of the privileges and immunities granted to both organisations on a functional need basis, and other facilities. Furthermore, administration of the arrangements will be resourced from the existing resources responsible for managing privileges and immunities with international organisations in the UK.

The Bill strengthens our commitment to the work of the Commonwealth and our support of democratic legislators through our work with the CPA. It will also support the FCDO’s global humanitarian objectives, ensuring that the UK remains at the heart of an unrivalled global network for economic, diplomatic and security partnerships through our work with the ICRC.

Hon. Members raised a couple of points, which I will turn to before concluding. I was grateful to my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) for a wide ranging, informative and typically well-informed contribution. Craving your indulgence, Madam Deputy Speaker, may I take just a minute, as I am conscious that my hon. Friend has announced that she will not seek re-election at the next general election, and who knows whether I will get another opportunity at the Dispatch Box? Let me put on record my gratitude to her for everything she has done. She and I served together as fellow ward councillors on Westminster City Council before I was elected to this place and she was subsequently elected. She is a fierce champion for what she believes to be right for her constituents and her community, and she has demonstrated that as a councillor and leader of the council and now as a Member of Parliament. She will be hugely missed by her constituents and by this House.

My hon. Friend the Member for Hyndburn (Sara Britcliffe) asked what support His Majesty’s Government will give, beyond this legislation, to both the organisations that we are debating. His Majesty’s Government give the ICRC £48 million of core funding annually, and up to £100 million in bilateral donations. We have a long-standing and robust relationship with the ICRC and a track record of supporting it. My understanding is that we fund CPA International to the tune of £196,000, and we give CPA UK £235,000. We support them through not only this legislation and what we say in this House but tangible financial support.

In an ever more challenging global context, His Majesty’s Government and my right hon. Friend the Foreign, Commonwealth and Development Secretary remain committed to working with and supporting the work of the CPA and the ICRC. This Bill gives both organisations the status in legislation that they need and deserve to continue their international operations without impediment; it reflects our commitment. I once again congratulate my right hon. Friend the Member for Basingstoke. The Government continue to support the Bill, and I commend it to the House.

[Madam Deputy Speaker (Dame Rosie Winterton)]

With the leave of the House, I call Dame Maria Miller to wind up the debate.

Health and Care Bill

Debate between Edward Argar and Rosie Winterton

Consideration of Lords amendments
Monday 25th April 2022 Commons Chamber

[The Minister for Health (Edward Argar)]

I beg to move, That this House disagrees with Lords amendment 29B in lieu.

[Madam Deputy Speaker]

With this it will be convenient to consider the following:

Lords amendments 30B and 108B to words restored to the Bill, Government motion to disagree, and Government amendments (a) to (i) in lieu.

Lords amendment 48B in lieu, Government motion to disagree and Government amendment (a) in lieu.

Government motion to insist on disagreement with Lords amendment 80, insist on Commons amendments 80A to 80N in lieu, and disagree with Lords amendments 80P and 80Q.

[Edward Argar]

The Lords amendments before the House today relate to the NHS workforce, reconfigurations, modern slavery and the adult social care cap. In respect of amendments 30B and 108B on reconfigurations, I am grateful for the constructive debate on these issue across both Houses. This House has twice voted strongly in favour of the ability for the Secretary of State to call in reconfiguration proposals when needed, and it remains a key principle that decisions on how services are delivered should be subject to ministerial oversight. However, my right hon. Friend the Secretary of State and I have listened carefully to the debates throughout the Bill’s passage, and as a result we have proposed a series of amendments to minimise bureaucracy and ensure transparency.

The first set of changes would mean that the NHS had to notify the Secretary of State only about those reconfiguration proposals that were deemed notifiable, which we will define through regulations. We intend to align that definition with the existing duty on NHS commissioners to consult local authorities where there is a substantial development of variation in the health service. We also propose to remove the requirement for commissioners and providers to inform Ministers of

“circumstances that are likely to result in the need for the reconfiguration of NHS services”.

Taken together, these changes will mean that the NHS will need to notify the Secretary of State only about proposals that are substantive and of great importance to people.

Secondly, we will give local authorities, NHS commissioners and anyone else the Secretary of State considers appropriate a right to make representations to the Secretary of State when he has called in a proposal for reconsideration. We expect this to include any relevant provider. The Secretary of State will be required to publish a summary of the representations he receives, and we will set out in statutory guidance further detail on how local bodies, including providers, will be engaged.

Thirdly, transparency is vital to ensure that these powers are always used by Ministers in the clear interest of the people we all serve. We will therefore require the Secretary of State to provide the reasons for his decisions and directions when he makes them. Finally, we have heard throughout these debates that it is vital that decisions are made expeditiously and expediently in order to give certainty to local bodies so that reconfigurations can be made quickly to improve the quality of services received by patients. We are therefore introducing a requirement that, once a reconfiguration proposal has been called in, the Secretary of State must make any decisions within six months. We believe that this set of changes addresses the key concerns raised in this House and the other place, and I commend it to the House.

I turn to Lords amendment 48B, and the Government’s amendment in lieu, on modern slavery. We share the strength of feeling expressed in both Houses on ensuring that the NHS is in no way inadvertently linked with modern slavery and human trafficking through its supply chain. That is why the Government brought forward an amendment in the first round of ping-pong to create a duty on the Secretary of State to undertake a thorough review of NHS supply chains. I am pleased to announce today that we are going further. The Government’s amendment in lieu of Lords amendment 48B will require the Secretary of State to make regulations with a view to eradicating the use by the NHS in England of goods or services tainted by slavery or human trafficking. The regulations can set out steps the NHS should be taking to assess the level of risk associated with individual suppliers, and the basis on which the NHS should exclude them from a tendering process.

I particularly commend my right hon. Friend the Member for Chingford and Woodford Green (Sir Iain Duncan Smith) for his consistent and vocal campaigning on this issue. I am delighted that he has confirmed his support for the amendment in lieu. I look forward to working further with him and his supporters to bring these measures forward.

Integration White Paper

Debate between Edward Argar and Rosie Winterton

Wednesday 9th February 2022 Commons Chamber

[Edward Argar]

As I mentioned in my earlier answers, this White Paper needs to be taken in conjunction with what we announced yesterday in respect of waiting list recovery, the September social care White Paper and, more broadly, our approach to growing our nursing profession, through increasing the skills and numbers in that profession. We are already well on target for 50,000 more nurses in the profession.

This White Paper looks at the specific aspect of the integration of social care and health and permissive ways for local areas to come up with their most effective place-based arrangements, many of which are already in development. It is, quite rightly, not specific about any individual profession, nor do we believe it should be, because it is for local places to develop their own local plans to reflect their local needs.

[Madam Deputy Speaker]

I thank the Minister for his statement.

Health and Social Care

Debate between Edward Argar and Rosie Winterton

Friday 3rd December 2021 Commons Chamber

[Edward Argar]

Charming as ever.

We are the party of our NHS. We are backing it with the resources and support that it needs to get through this winter.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I thank the Minister for his undertaking about brief answers, and I urge Members to ask brief questions as well. Otherwise we will not get everyone in, because we do need to return to the private Member’s Bills.

[Sir Bernard Jenkin (Harwich and North Essex) (Con)]

I thank my hon. Friend for his statement. Can he confirm that it is the Government’s policy to encourage the reopening of mass vaccination centres to get through the bulge of booster jabs that we need? In that regard, will he congratulate the South Suffolk & North East Essex integrated care system, which has once again secured facilities at Harwich international port, and will he thank the port for offering those facilities again? We are hoping for a mass vaccination session on 19 and 20 December, and further sessions in January. Is that not the way to take the pressure off GPs?

--- Later in debate ---

[Ruth Edwards (Rushcliffe) (Con)]

I welcome the £131 million for the midlands that the Minister has announced today. I am very aware, though, that my constituents in East Leake are being served by a health centre that is the oldest in Nottinghamshire and which is far too small for the population growth that we have seen in recent years. Twenty months ago, the then Parliamentary Under-Secretary of State for Health and Social Care—my hon. Friend the Member for Bury St Edmunds (Jo Churchill)—promised at the Dispatch Box that we would have a ministerial visit to East Leake so that the Department could see what we were dealing with. I completely understand that that was impossible at the height of the pandemic, but that has long passed, so will the Minister recommit to that visit today and take that request back to his Department, because despite repeated chasing by me and my office staff, we cannot get a date from it in the diary?

[Madam Deputy Speaker]

Order. It is very important that we do not go off the boil in terms of briefness of questions. The Minister is being very good at being brief in his answers.

[Edward Argar]

It would be easy to commit the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), to a visit because she is not here. Equally, I am conscious that East Leake is just up the road from my constituency, so it may be that my hon. Friend gets me instead. I will certainly look into that visit.

--- Later in debate ---

[Edward Argar]

Absolutely, I can give my hon. Friend that assurance. He rightly alludes to the fact that the inputs are important, but for those of us on the Government Benches, it is the results they bring—the outputs—and what we do with the money that matter. We will ensure that that money is well spent, harnesses innovation and delivers even better patient care and access to his constituents and many others.

[Madam Deputy Speaker]

I thank the Minister for his statement. We return to debate on the private Member’s Bill.

Health and Care Bill

Debate between Edward Argar and Rosie Winterton

Report stage
Monday 22nd November 2021 Commons Chamber

[Edward Argar]

I beg to move, That the clause be read a Second time.

[Madam Deputy Speaker (Dame Rosie Winterton)]

With this it will be convenient to discuss the following:

New clause 33—Support provided by the NHS to victims of domestic abuse—

“(1) Each Integrated Care Board must—

(a) assess, or make arrangements for the assessment of, the need for support for victims of domestic abuse using their services;

(b) prepare and publish a strategy for the provision of such support in its area;

(c) monitor and evaluate the effectiveness of the strategy;

(d) designate a domestic abuse and sexual violence lead; and

(e) publish an annual report on how it has discharged its duties relating to the provision of services to victims of domestic violence under the Care Act 2014.

(2) An Integrated Care Board that publishes a strategy under this section must, in carrying out its functions, give effect to the strategy.

(3) Before publishing a strategy under this section, an Integrated Care Board must consult—

(a) any local authority for an area within the relevant Integrated Care Board’s area;

(b) the domestic abuse local partnership board appointed by the local authority for an area within the relevant clinical commissioning group’s area under section 58 of the Domestic Abuse Act 2021; and

(c) such other persons as the relevant local authority considers appropriate.

(4) For the purposes of subsection (4), ‘local authority’ means—

(a) a county council or district council in England; or

(b) a London borough council.

(5) An Integrated Care Board that publishes a strategy under this section—

(a) must keep the strategy under review;

(b) may alter or replace the strategy; and

(c) must publish any altered or replacement strategy.

(6) The Secretary of State may by regulations make provision about the preparation and publication of strategies under this section.

(7) The power to make regulations under subsection (7) may, in particular, be exercised to make provision about—

(a) the procedure to be followed by an Integrated Care Board in preparing a strategy;

(b) matters to which an Integrated Care Board must have regard in preparing a strategy;

(c) how an Integrated Care Board must publish a strategy;

(d) the date by which an Integrated Care Board must first publish a strategy; and

(e) the frequency with which an Integrated Care Board must review its strategy or any effect of the strategy on the provision of other provision in its area.

(8) Before making regulations under this section, the Secretary of State must consult—

(a) all Integrated Care Boards; and

(b) such other persons as the Secretary of State considers appropriate.”

This new clause would require Integrated Care Boards to publish a strategy for the provision of support for victims of domestic abuse using their services and designate a domestic abuse and sexual violence lead.

New clause 55—Guidance for babies, children and young people—

“(1) The Secretary of State must publish guidance on how integrated care systems should meet the needs of babies, children and young people aged 0-25.

(2) Integrated care systems must act in accordance with the guidance in subsection (1).”

This new clause would require the Secretary of State to publish guidance on how integrated care systems should meet the needs of babies, children and young people aged 0-25 and would require integrated care systems to act in accordance with the guidance.

New clause 57—NHS England’s duty as to reducing inequalities—

“Section 13G of the National Health Service Act (duty as to reducing inequalities), is amended by the addition of the following subsections—

‘(2) NHS England must publish guidance about the collection, analysis, reporting and publication of performance data by relevant NHS bodies with respect to factors or indicators relevant to health inequalities.

(3) Relevant NHS bodies must have regard to guidance published by NHS England under this section.

(4) In this section “relevant NHS bodies” means—

(a) NHS England,

(b) integrated care boards,

(c) integrated care partnerships established under section 116ZA of the Local Government and Public Involvement in Health Act 2007,

(d) NHS trusts established under section 25, and

(e) NHS foundation trusts.’”

Amendment 47, in clause 6,  page 4, line 11, at end insert—

“(5) In paragraph 1(a) ‘relevant public body’ means a public authority listed under the title ‘Health, social care and social security’ in Part 1 of Schedule 19 to the Equality Act 2010 or an NHS Trust.”

This amendment provides that NHS England resources for supporting or assisting organisations that are providing or planning to provide health services may only be directed to public sector bodies.

Amendment 58, in clause 12, page 8, line 6, at end insert—

“(2) An integrated care board may not—

(a) delegate that function; and

(b) exercise that function to enter into an integrated care provider contract with any body other than a statutory NHS body.

(3) In paragraph (2)(b) an ‘integrated care provider contract’ has the same meaning as in Schedule 3A of the National Health Service (General Medical Services Contracts) Regulations 2015.”

This amendment is designed to ensure that an organisation carrying out the functions of an ICB on its behalf is a statutory NHS body.

Amendment 59, page 12, line 29 at end insert—

“(3A) Nothing in——

(a) the rules referred to in subsection (1),

(b) this Act, or

(c) any regulations made under this Act

(none) shall entitle any provider of health services to withhold provision of those services from any individual on the basis of the integrated care board to which that individual has been allocated.”

This amendment is to ensure that any providers of health services cannot withhold provision of those services from any individual because of the integrated care board that they have been allocated to.

Amendment 66, in clause 15, page 13, line 44, at end insert—

“(j) palliative care services.”

This amendment adds a requirement for the commissioning of palliative and end of life care services.

Amendment 21, page 14, line 43, at end insert—

“3AA Duty of integrated care boards to commission approved treatments

‘(1) This section applies where—

(a) a treatment has been approved by the National Institute for Health and Care Excellence, and

(b) an integrated care board has not arranged for the provision of that treatment under section 3 or 3A of this Act, and

(c) a clinician has recommended that treatment for a person for whom that integrated care board has responsibility.

(2) The integrated care board referred to in subsection (1) must arrange for the provision of that treatment to the person for whom it has responsibility.

(3) In subsection (1) “clinician” means a medical professional employed by or acting on behalf of an NHS Trust, NHS Foundation Trust or primary care service from whom the integrated care board has arranged for the provision of services.’”

This amendment would require an integrated care board to arrange for the provision of a NICE-approved treatment to any patient whose NHS clinician has recommended it, even if that treatment is not otherwise available to patients in that ICB area.

Amendment 48, in clause 19,  page 16, line 6, leave out “promotes” and insert

“secures the rights set out in”.

This amendment requires ICBs to act to ensure that health services are provided in a way which secures the rights set out in the NHS Constitution.

Amendment 99, page 16, line 34, at end insert—

“(2) In fulfilling their duties under this section, integrated care boards must have particular regard to the need to reduce inequalities between migrant and non-migrant users of health services.”

Amendment 49, page 16, line 37, leave out “promote” and insert “enable”.

This amendment, together with Amendment 50 provides that ICBs enable the involvement of patients, their paid and unpaid carers, and their representatives in decisions relating to the prevention or diagnosis of illness, care or treatment, rather than promoting their involvement.

Amendment 50, page 16, line 37, after “their”, insert “paid and unpaid”.

This amendment, together with the Amendment 49, provides that ICBs enable the involvement of patients, their paid and unpaid carers, and their representatives in decisions relating to the prevention or diagnosis of illness, care or treatment.

Amendment 22, page 17, line 4, at end insert—

“14Z37A Obligation on integrated care boards to ensure appropriate uptake of all NICE approved products according to population need

‘(1) Each integrated care board must promote uptake of all NICE approved medicines and medical devices in accordance with the need of the population it serves.

(2) An integrated care board must, in each financial year, prepare a report on the uptake of all NICE approved medicines and medical devices, including the number of patients that have accessed each product.’”

This amendment would require ICBs to ensure that all NICE approvals are available and promoted to their population, and report on this uptake annually.

Amendment 19, page 17, line 14, at end insert—

“14Z39A Duty to review latest innovations with a view to local commissioning

(1) Integrated care boards must review all new—

(a) medicines,

(b) medical devices, and

(c) other health care solutions that may benefit the local population.

(2) Integrated care boards must—

(d) appoint a dedicated innovation officer to their board, and

(e) develop and maintain a system to keep up to date with medicines and devices innovation and review suitability for patient usage, including engagement with the relevant—

(i) academic health science network, and

(ii) local pharmaceutical committee.”

This amendment would mandate integrated care boards to monitor and assess innovation for the benefit of the local population.

Amendment 16, page 17, line 19, at end insert—

“(2) Each integrated care board must each year prepare, consult on and adopt a research strategy for patient benefit which—

(a) meets local need;

(b) meets national research undertakings.

(3) In developing a strategy under subsection (2), an integrated care board must engage with—

(a) the National Institute for Health Research,

(b) academic health science networks, and

(c) all other relevant regional and national health research organisations.”

This amendment would require ICBs to establish a research strategy and other connected measures.

Amendment 91, page 18, line 18, after first “the” insert “physical and mental”.

This amendment will require Integrated Care Boards to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness replicating the parity of esteem duty as introduced in the Health and Social Care Act 2012.

Amendment 92, page 18, line 23, after first “of” insert “physical and mental”.

This amendment will require Integrated Care Boards to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness replicating the parity of esteem duty as introduced in the Health and Social Care Act 2012.

Amendment 68, page 18, line 26, at end insert—

“(d) health inequalities.”

This amendment would modify the triple aim to explicitly require integrated care boards to take account of health inequalities when making decisions.

Amendment 17, page 18, line 38, at end insert—

“14Z43A Duty on integrated care boards to consider requests to engage in clinical trials, and patient participation

(1) An integrated care board must consider any request from the organiser of an authorised clinical trial for the ICB to engage in that trial.

(2) If such a request is accepted, the integrated care board must offer the ability to participate in the trial to any patient within their area who is eligible to take part.”

This amendment would require integrated care boards to consider any requests to engage in clinical trials and offer patients the opportunity to participate.

Amendment 20, page 18, line 38, at end insert—

“14Z43A Duty to update formularies to include all NICE-approved products

(1) Within 28 days of any medicine or device receiving market authorisation from NICE, an integrated care board must update its formulary to include that medicine or device.

(2) On receipt of notice of the market authorisation by NICE of any medicine or device, an integrated care board must immediately instruct providers of health and care services commissioned by the board to update their formularies in such a way that all NICE-approved medicines and devices are available to patients on the recommendation of a healthcare practitioner within 28 days of market authorisation.

(3) An integrated care board must report annually all medicines and devices that have been added and removed from their formulary over the previous year.”

This amendment would mandate integrated care boards and healthcare providers (e.g. hospital trusts) to update their formularies to include all NICE-approved medicines or devices within 28 days of market authorisation to ensure they are available for healthcare practitioners (e.g. physician or prescribing pharmacist) to make available for suitable patients.

Amendment 102, page 21, line 25, at end insert—

“(c) set out any steps that the integrated care board proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults).”

This amendment requires the joint forward plan for an integrated care board and its partners to set out any steps it proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults).

Amendment 51, page 22, line 23, leave out

“in a way that they consider to be significant.”

This amendment requires ICBs and partner NHS Trusts and NHS Foundation Trusts to consult on all revisions to their forward plans.

Amendment 52, page 23, line 42, at end add “on its website”.

This amendment is to require capital resource use plans to be made publicly available on the internet.

Amendment 53, page 24, line 22, leave out

“in a way that they consider to be significant”.

The purpose of this amendment is to require all revisions of capital resource use plans to be published.

Amendment 18, page 25, line 6, at end insert—

“(d) explain what research activity it undertook during the year, including

(i) research to meet local health issues, and

(ii) research to support national research projects.

‘(2A) The annual report prepared by the Secretary of State under section 247D of this Act must include a section which reproduces, and comments on, the sections of the annual reports of each integrated care board prepared under paragraph (1)(d).’”

This amendment would require integrated care boards to publish an account of their research activity, and require the report the Secretary of State must prepare and lay before Parliament under section 247D of the National Health Service Act 2006 to include a section which reproduces, and comments on, the research activity of all ICBs.

Amendment 23, page 25, line 14, at end insert—

“14Z56A Report on assessing and meeting parity of physical and mental health outcomes

(1) An integrated care board must annually set out in a report the steps it has taken to fulfil its obligations to deliver parity of esteem between physical and mental health to its local population.

‘(1) The report must set out—

(a) the number of patients presenting with mental health conditions,

(b) the number of patients presenting with physical health conditions,

(c) the number of mental health patients waiting for initial assessment,

(d) the number of physical health patients waiting for initial assessment,

(e) the number of mental health patients waiting for treatment,

(f) the number of physical health patients waiting for treatment,

(g) the number of mental health patients receiving treatment,

(h) the number of physical health patients receiving treatment,

(i) the number of patients readmitted to mental healthcare settings, and

(j) the number of patients readmitted to physical healthcare settings.

(2) The report must set out performance against nationally set standards in both physical and mental health.

(3) Each year the Secretary of State must lay before Parliament a consolidated report of all the reports made by integrated care boards under this section, and make a statement to each House of Parliament on the report.’”

This amendment would require an ICB to report on assessing and meeting parity of physical and mental health outcomes.

Amendment 15, in clause 20,  page 29, line 20, at end insert—

“(2A) The Secretary of State may by regulations make provision about representation of particular health, social care, and local interests, clinical fields, and types of health or care provision in the membership of integrated care partnerships.”

This amendment would enable the Secretary of State to make provision about the membership of integrated care partnerships.

Amendment 100, page 29, line 22, at end insert—

“(4) A member of the Integrated Care Partnership may not work for, be the representative of or hold financial interest in any private company delivering or seeking to deliver health and care services or services supporting the health and care sector or producing or seeking to produce health and care products, with the exception of general practitioners.”

This amendment seeks to ensure that Integrated Care Partnerships are made up wholly of representatives from public sector organisations and that private companies are not represented on them.

Amendment 1, page 29, line 45, at end insert—

“(c) fully integrate the promotion of everyday wellbeing, self-care for minor ailments and the management of long-term conditions into local health systems.”

This amendment would ensure that everyday wellbeing, self-care for minor ailment and management of long term conditions are integrated and promoted into local health systems.

Amendment 2, page 30, line 3, after “services” insert

“including services provided by pharmacists for minor ailments”.

This amendment would ensure that integrated care partnerships include in a strategy its views on how health-related services, including provision for self-treatable conditions, are integrated into health and social care services in that area.

Amendment 69, in clause 23,  page 35, line 32, at end insert—

“(5) NHS England must publish guidance on the means by which an integrated care board, NHS trust or NHS foundation trust which believes its capital resource limit or revenue resource limit risks compromising patient safety may object to the limit set.”

Amendment 114, in clause 25,  page 37, line 27, at end insert—

“(2A) The priorities set by the Secretary of State under subsection (2)(a) must include priorities relating to leadership, the integration of services and the quality and safety of services.”

The Secretary of State has the function of setting priorities for the Care Quality Commission in carrying out assessments in relation to integrated care systems. This amendment requires the Secretary of State to set priorities relating to certain matters.

Amendment 61, in clause 64, page 59, line 27, leave out from beginning to end of line 28.

This amendment is to ensure that a commissioner cannot also be a provider.

Amendment 62, in clause 69, page 63, line 30, leave out “may” and insert “must”.

This amendment makes it a requirement that regulations make provision in relation to the procurement by relevant authorities of (a) health care services for the purposes of the health service in England, and (b) other goods or services that are procured together with those health care services.

Amendment 63, page 63, line 36, leave out “may” and insert “must”.

This amendment makes it a requirement that regulations make provision in relation to (a) general objectives of procurement, and (b) procurement processes.

Amendment 64, page 63, line 39, leave out “may” and insert “must”.

This amendment along with Amendment 65 makes it a requirement that regulations make provision for the purposes of (a) ensuring transparency and fairness in relation to procurement, and (b) ensuring that compliance can be verified, or managing conflicts of interest.

Amendment 65, page 63, line 41, leave out “or” and insert “and”.

This amendment is to make it a requirement for regulations to make provision to ensure both transparency and fairness in relation to procurement.

Amendment 9, page 64, line 1, at end insert—

“(3A) The regulations must provide that—

(a) there is a presumption—

(i) in favour of contracts being awarded to NHS trusts and NHS foundation trusts, and

(ii) that integrated care provider contracts will not be awarded to a body other than to an NHS trust or an NHS foundation trust, except for under the provisions of paragraph (b);

(b) if an NHS trust or an NHS foundation trust does not consider that it is able, or does not wish, to provide certain services under a contract, it must publish its reasons;

(c) if paragraph (b) applies, the integrated care board must consult the public if it proposes to award any contract for those services to any body other than an NHS trust or NHS foundation trust;

(d) a consultation under paragraph (c) must—

(i) set out the responses of the integrated care provider to the reasons given by the NHS trust or NHS foundation trust under paragraph (b),

(ii) specify the proposed parties to and the full terms and conditions of the proposed contract, and

(iii) specify that the terms and conditions for staff under the proposed contract must be at least equivalent to NHS terms and conditions.”

This amendment would make NHS trusts and foundation trusts the default providers of NHS services.

Amendment 72, page 64, line 1, at end insert—

“(3A) The regulations must make provision in relation to the procurement of the services referred to in paragraph (1)(a) (other than primary medical services, primary dental services and primary ophthalmology services) that before any contract for a service with an annual value in excess of £5m may be awarded to an organisation that is not an NHS trust or NHS foundation trust—

(a) the business case for the award of the contract must be published;

(b) any responses to the proposal in the business case must be considered and published;

(c) the process for awarding the contract must be open and transparent and non-discriminatory at every stage, including (but not limited to)—

(i) procurement strategy and plan,

(ii) invitation to tender,

(iii) responses to invitations,

(iv) evaluation of tenders,

(v) decision to award, and

(vi) contract awarded;

(d) the process for awarding the contract must demonstrate due regard to the principles established in the Public Contracts Regulations 2015 (S.I.2015/102) or any regulations which may supersede them;

(e) in any case where it is claimed that an emergency justifies an award without the process being used then the responsible body must within 14 days publish the business case for the award of the contract and the record of the decision.”

Amendment 101, in schedule 2,  page 125, line 26, at end insert—

“(3) Members of an Integrated Care Board may not work for, be the representative of or hold financial interest in any private company delivering or seeking to deliver health and care services or services supporting the health and care sector or producing or seeking to produce health and care products, with the exception of general practitioners.”

This amendment seeks to ensure that ICBs are made up wholly of representatives from public sector organisations and that private companies, their employees and representatives, and those with financial interests in them, are not represented on ICBs.

Government amendments 25 to 28.

Amendment 76, page 126, line 26, at end insert—

“(d) at least one member nominated by the mental health trust or trusts that provide mental health services within the integrated care board’s area;

(e) at least one member nominated by the Directors of Public Health that serve each local authority within the integrated care board’s area;

(f) at least one member nominated jointly by any NHS trust, NHS foundation trust and local authority that provides social care services within the integrated care board’s area;

(g) at least one member nominated by the trade unions representing the health and social care workforce that serves the integrated care board’s area;

(h) at least one member appointed to represent the voice of patients and carers in the integrated care board’s area.”

Amendment 77, page 126, line 26, at end insert—

“(2A) The constitution must prohibit representatives of GP practices with active Alternative Provider Medical Services contracts from becoming members.”

This amendment would mean that the only GPs able to participate in Integrated Care Boards would be those whose practices are on the standard General Medical Services (GMS) contract.

Amendment 78, page 126, line 26, at end insert—

“(2A) Representatives of private providers of healthcare services, other than general practitioners who hold a contract for the provision of primary medical services in the area, may not be appointed to NHS decision-making boards, integrated care boards, or any place-based committee or sub-committee of the boards.”

Amendment 81, in schedule 2,  page 130, line 14, at end insert—

“(7) An integrated care board may enter into an externally financed development agreement in respect of any Local Improvement Finance Trust relevant to the area for which it has responsibility and receive the income related to that agreement.

(8) An integrated care board may enter into an externally financed development agreement in respect of any proposed Local Improvement Finance Trust relevant to the area for which it has responsibility.”

This amendment would enable integrated care boards to participate in existing and future LIFT schemes and to receive the income that would come to the local area from the local investment in such schemes.

Amendment 79, in schedule 3,  page 132, line 28, leave out “person” and insert

“general practitioner, GP partnership or social enterprise providing primary medical services”.

This amendment would prevent an integrated care board from entering into or renewing any Alternative Provider Medical Services (APMS) contract.

Amendment 80, page 132, line 32, leave out “person” and insert

“general practitioner, GP partnership or social enterprise providing primary medical services”.

This amendment would prevent NHS England from entering into or renewing any Alternative Provider Medical Services (APMS) contract.

Government amendments 29 and 30.

[Edward Argar]

New clause 49 has attracted a slightly fuller House than my previous speech did. This additional clause relates to the cap on care costs for charging purposes.

On 7 September, my right hon. Friend the Prime Minister took the bold step of publishing “Build Back Better: Our Plan for Health and Adult Social Care”. Successive Governments over decades have failed to tackle the reform of social care. This Government are delivering a package—package is the key—of reforms that will not only tackle the wider challenges faced by the adult social care system but reform how social care is funded to ensure that everyone, regardless of where they live or their level of assets, is protected from catastrophic costs. Let me remove all doubt on this issue: no one will lose from these reforms, compared with the system we have now, and the overwhelming majority will win.

Underpinning the reforms set out in the plan is an additional £5.4 billion over the next three years. That funding will end wholly unpredictable care costs and include at least £500 million to support the adult social care workforce. The reforms will make a real difference to the frontline of adult social care, including care users and the dedicated care workforce who have performed heroics throughout the pandemic. A crucial element of the reforms in the plan are the proposals to reform the existing social care charging rules.

Covid-19

Debate between Edward Argar and Rosie Winterton

Monday 22nd February 2021 Commons Chamber

[Edward Argar]

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

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

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

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

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

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

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

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

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

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

[Madam Deputy Speaker (Dame Rosie Winterton)]

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