Health and Care Bill

Debate between Edward Argar and Wes Streeting

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Edward Argar]

My hon. Friend puts his finger on a key issue, which is the dynamic nature of workforce trends, whether in terms of demand or supply, which is one of the challenges of a long-term projection—it would need to be a dynamic process. That is why we believe that the right approach is the one set out by my right hon. Friend the Secretary of State. His predecessor commissioned that framework review from Health Education England in July last year, and the Secretary of State has subsequently asked for further work to be done in a further commission that looks at a workforce framework over 15 years. That is the first time that has been done, as I heard him say at the Dispatch Box earlier today when talking about the Ockenden review, and it will be a hugely valuable tool for the NHS and for us when we make decisions in this place about priorities and prioritisation in healthcare. As always, I am grateful to my hon. Friend the Member for Waveney (Peter Aldous).

Before I go into more detail, I will make a point on which I suspect the shadow Secretary of State and I are in complete agreement. Although there may not be many things in this group of amendments that we agree on, I am sure that he will join me in recognising the amazing work done by our health and care workforce over the past two years, and not just in the past two years, which were exceptional circumstances, but every day of the year—day in, day out—whichever year it is. I put that on record because it is important.

[Wes Streeting (Ilford North) (Lab)]

indicated assent.

[Edward Argar]

The hon. Gentleman nods; as I say, I suspect that may be a rare moment of agreement on this group of amendments.

We continue to be committed to growing and investing in the workforce. This year we have seen record numbers of staff working in NHS trusts and clinical commissioning groups, including record numbers of doctors and nurses. The monthly workforce statistics for December 2021 show that there are more than 1.2 million full-time equivalent staff. Those workforce numbers come on the back of our record investment in the NHS, which is helping to deliver our manifesto commitments, including to have 50,000 more nurses by the end of the Parliament. We are currently on target to meet that manifesto commitment, as the number of nurses was a little over 27,000 higher in December 2021 than in September 2019.

The spending review settlement will also underpin funding the training of some of the biggest undergraduate intakes of medical students and nurses ever. In that context, I highlight the decision made, I believe, under one of my predecessors to expand the number of medical school places from 6,000 to 7,500, which has come on stream. Of course there is a lead time before those going through medical schools will be active in the workforce, but it is an important step forward.

Elective Care Recovery in England

Debate between Edward Argar and Wes Streeting

Monday 7th February 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the publication of his Department’s plan for elective care recovery in England.

[The Minister for Health (Edward Argar)]

The covid-19 pandemic has had a huge impact on healthcare systems everywhere. The NHS has performed incredibly, caring for covid and non-covid patients alike and delivering the vaccination programme that has helped us to open up this country once again. Throughout the pandemic, we had to take steps to ensure that we could treat those with the greatest clinical need and that we provided a safe environment for those who needed covid care.

As a result, there is undeniably a huge covid backlog that needs urgent attention. The number of people waiting for care in England now stands at about 6 million, and we know that that figure will get worse before it gets better. Furthermore, our best current estimate is that about 8.5 million people who would normally come forward for treatment have not done so during the pandemic. However, we are pulling out all the stops to help the NHS recover and ensure that patients are receiving the right care at the right time.

Hon. Members will be aware that the Government will have invested more than £8 billion in the NHS in the three years from 2022-23 to 2024-25. As part of the new health and social care levy, we will be putting huge levels of investment into health and social care over the coming three years, and all the time we are announcing new solutions to the problem of how we can ensure that the NHS is on the firmest possible footing for the future.

On Friday we launched a call for evidence that will inform an ambitious new vision for how we lead the world in cancer care. As the Prime Minister announced earlier today, we are setting out some tough targets for the NHS on cancer. We want to ensure that 75% of patients are diagnosed or have cancer ruled out within 28 days of a GP referral, and to return the backlog of people waiting more than two months for their cancer treatment to pre-pandemic levels by March 2023. Today the NHS has also announced the launch of a new platform, My Planned Care, which will provide patients and their carers with relevant and up-to-date information ahead of planned treatment, including information on waiting times for their provider.

I am under no illusions about the fact that our health system is facing an enormous and unprecedented challenge. That is why we are doing everything in our power to support the NHS and its patients, recovering services to reduce waiting times and deliver more checks, operations and treatments. We are faced with a once-in-a-generation challenge. We know that we must get this right. We are working with the NHS and across Government to deliver a targeted and far-reaching plan for elective recovery, and we will update the House at the earliest possible opportunity.

[Wes Streeting]

Thank you for granting the urgent question, Mr Speaker.

This is not a covid backlog; it is a Tory backlog. We went into the pandemic with NHS waiting lists already at a record 4.5 million, and now 6 million people are waiting on those lists—more than ever before. More than 1 million are waiting for scans and tests used to diagnose cancer, and the NHS itself is waiting—waiting for the Government’s plan to deal with the backlog. So where is it? It was due to be published today but was pulled last night. It is like something from “The Thick of It”, but the reality is worse than fiction—a photo op without a plan; the Government’s own NHS recovery plan just another cancelled operation. But there is no need to worry, because there is a website coming that will tell people that they are waiting a long time, even if there is no plan to ensure that they do not-.

Then there is the “reason” for the delay. Briefings from the Department for Health and Social Care claimed that the Chancellor had blocked the plan. As one Government official said,

“it’s pretty obvious it’s about Treasury reluctance to rescue the PM”.

Is this where the shambles of the Conservative party is taking us? Is the Chancellor seriously playing political games while 6 million people wait for care? No wonder the Health Secretary has not bothered to show his face this afternoon. He is probably still recovering from the embarrassment of this morning’s media round, where the big announcement was literally that there was no announcement. So it has been left to the Prime Minister to clear things up, which tends to go almost as well as breakfast television with the Culture Secretary. No wonder she has been dispatched to the middle east.

Let me turn to the “tough targets” that the Minister mentioned. Today the Prime Minister announced a new target that no one should wait longer than two months for cancer diagnosis, but there is already a target for the vast majority of cancer patients to be treated within two months of referral, and it has not been hit since 2015. Is this not just another example of the Conservatives lowering standards for patients because they consistently fail to meet them? The Prime Minister has also announced that three out of four patients should receive a cancer diagnosis within 28 days, but that is an existing target that was introduced last April and has never been met.

The waiting list crisis is the chickens coming home to roost after more than a decade of Tory failure. The Treasury blocked a plan for staffing and it is now blocking the plan to cut waiting times. Is it not now clear, amid the chaos, confusion and spectacular incompetence on display, that the longer we give the Conservatives in government, the longer patients will wait?

[Edward Argar]

I am grateful to the shadow Secretary of State. As he said, 2 million of those on the waiting list have entered that waiting list since the pandemic began. There is undoubtedly a huge covid backlog, as we had to put in place infection prevention and control measures and ensure the availability of beds for those with covid. I am with him, I suspect, on at least one point, which is that I, like him, entirely understand the impact that this has on people’s lives, their anxiety and their health outcomes. That is why this Government are determined to tackle that waiting list. As I said, this is a once-in-a-generation challenge and it is absolutely right that we make sure we get the plan right. We need to ensure that we have the right plan, delivering the right outcomes.

The hon. Gentleman mentioned delays, and I have to say that this plan is delayed. This is a plan we anticipated publishing in December. The reason that we did not do that was because of the omicron variant and the impact it has had on our health services over the winter. We have made sure that we get this plan right.

The hon. Gentleman also mentioned Her Majesty’s Treasury. I have to say, speaking as a Minister in the Department of Health and Social Care, that we could not wish for better partners than Her Majesty’s Treasury and this Chancellor. They have shown strong support to our health and care system throughout the pandemic, with record levels of funding to support it through the pandemic and to help performance to recover subsequently.

Even before the pandemic, when the current Secretary of State for Health was Chancellor, this Government had already put in place a £33.9 billion increase in funding, enshrined in law. It was one of the first pieces of legislation passed by this Government after the election. We have also set out our long-term funding plans through the health and care levy, which I recall the hon. Gentleman’s party did not support.

Covid-19: Purchasing Effort

Debate between Edward Argar and Wes Streeting

Thursday 3rd February 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I thank the Minister for advance sight of the statement. But what a disgrace that the Secretary of State did not come to the House today, to account for the inexcusable and unacceptable level of waste in his Department, or when the Department first published the accounts, or two days afterwards, when they were reported on the front pages of several newspapers and on broadcast news. Perhaps the Secretary of State’s silence and absence tell us that he is relaxed about losing billions of pounds of taxpayers’ money, or perhaps it is simply that he is too ashamed to show his face. He had to be dragged to the House and when he was, he bottled it and sent his deputy.

The Department of Health and Social Care snuck out its annual accounts on the final day on which they were legally required, 10 months after the end of the financial year, and, I am sure by total coincidence, at 5.30 pm on the day Sue Gray published her update. Buried on page 199 was the revelation that the Department lost a staggering £8.7 billion on PPE. That is more than two thirds of the Department’s total spend on PPE written off as losses, double the amount it is spending on the hospital building programme, and almost as much as we spend on the salaries of every nurse in England for an entire year. Why? Because the PPE was unusable, going out of date, and bought in at eye-watering prices because the Government were in a state of desperation having run down our supplies before the pandemic arrived.

We know that many Conservative Members privately—sometimes even publicly—agree with Labour that the national insurance rise is an unfair hit on working families facing a cost of living crisis. How will they explain to their voters that, taken together with the £4.3 billion they handed out to fraudsters, this Government have thrown away more than a year’s receipts of the national insurance rise that they are now imposing on working families?

It is not just that the Conservatives are the party of high taxes because they are the party of low growth; they are the party of high taxes because they are the party of waste and incompetence. Think of what the NHS could have done with those funds. It could have reduced waiting lists and waiting times, improved access to GPs and rebuilt hospitals for the 21st century.

Of course covid came as a shock, but that does not explain why the Conservative Government ran down Britain’s supply of PPE before the pandemic, leaving us exposed to price hikes and profiteering. Perhaps the Minister can explain why a global pandemic necessarily leads to Conservative party donors and the former Secretary of State’s pub landlord receiving special treatment and hundreds of millions of pounds of taxpayers’ money.

It is not just PPE. Why did the Department fail to collect shipments from ports on time, costing taxpayers £111 million in additional fees? Why did the Department fail to pay its bills on time and incur late fees of £1.6 million as a result? Why did the Department spend £250 million on testing materials, ventilators and medical equipment, none of which can be used?

Is not it the case that when this Conservative Government thought no one was watching, they abandoned any pretence of being careful stewards of public finances, bunged millions to their mates and donors, and now working families are footing the bill? What would Mrs Thatcher, the grocer’s daughter, whose father instilled in her the value of thrift, make of this lot?

Is not the truth that the Conservative party has changed? You cannot trust this Conservative party to show respect to the people or to Parliament. You cannot trust this Conservative Party to keep taxes low. You cannot trust this Conservative Party to spend taxpayers’ money wisely. Indeed, the only thing that has not changed about the Conservatives is the age-old truth that you cannot trust the Tories with the NHS.

[Edward Argar]

It is always a pleasure to appear opposite the shadow Secretary of State. I will not take it as a personal affront that he would prefer it to be the Secretary of State rather than me.

The hon. Gentleman raised a number of important points. He cited Mrs Thatcher, and suggested that the Government had changed their position. If we are talking about sudden changes in position, I feel that I should quote the present shadow Chancellor, the hon. Member for Leeds West (Rachel Reeves)—formerly shadow Chancellor of the Duchy of Lancaster—who, in April 2020, wrote to my right hon. Friend the Chancellor of the Duchy of Lancaster:

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

She was right. I agreed with her sentiment then, and I still do—and we did do that—but it appears that the Opposition do not agree with it any more.

Let me turn to the hon. Gentleman’s other points. He kept suggesting—it makes a good headline for him, I am sure, but sadly I fear it is simply inaccurate—that this is money lost or wasted. It is not. As the hon. Gentleman knows from his days as a shadow Treasury Minister, this is a reflection of buying PPE at the height of the market, at the height of a global pandemic—

[Wes Streeting]

Why? Were there not enough masks?

[Edward Argar]

I will come to that point in a moment. It is a reflection of that, and now, in accounting terms, a reflection of what its value is today.

The hon. Gentleman should also be aware that the vast bulk of that £8.7 billion is down to exactly the same reason: PPE purchased at the height of the market. Now that we have a stable market, we have a sustainable supply. I make no apologies, and I know that my right hon. and hon. Friends will make no apologies, for doing exactly what the shadow Chancellor said we should do, which was to strain every sinew to make sure that the NHS had the PPE that it needed. We achieved that.

[Wes Streeting]

She did not say “by giving a contract to a pub landlord”.

[Edward Argar]

That is an important point, and I will turn to it in just a second.

The hon. Gentleman was also wrong to say that the money was thrown away. He knows that that is not what has happened here. He knows that this is about stock that has been written down in value, not written off. He knows that the vast bulk of that remaining is fit for use. We set very high standards in the NHS, but it is fit for use in other settings, and we are ensuring that we explore those other avenues, so that it can be used.

The hon. Gentleman talked about pub landlords. He will have heard my right hon. Friend the Member for West Suffolk (Matt Hancock) make this point in the Chamber. No contract was awarded to that individual, so I would caution him to be a little bit careful about the allegations he makes, and to check his facts before he does so.

Let me now turn to one of the broader themes raised by the hon. Gentleman. He talked about running down PPE stocks. Can he name any country in Europe that did not also have to buy vast amounts of PPE at the height of the pandemic, at the height of the market? This pandemic was unprecedented. We learned more about it with every day that passed. When we first started purchasing PPE, we were confronted with horrific pictures from hospitals in Bergamo in Italy. We saw the challenges that were faced, and we moved fast to ensure that our frontline had what it needed. We strained every sinew, and we got the PPE that our country needed.

Health and Social Care

Debate between Edward Argar and Wes Streeting

Friday 3rd December 2021 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I thank the Minister for advance sight of his statement. I pay enormous tribute to my predecessor, my right hon. Friend the Member for Leicester South (Jonathan Ashworth), who did a tremendous job as Labour’s longest-serving shadow Health and Social Care Secretary and worked constructively with the Government in response to the pandemic’s challenges. I intend to do the same.

In that spirit, I welcome this week’s announcements on the vaccine and booster roll-outs. I know from my own experience this year of kidney cancer and covid that some of the best people in our country work in health and social care. They are at the heart of my response.

NHS waiting lists stand at almost 6 million. Almost one in 10 people in England waits months or even years, often in serious pain and discomfort, because the Government have failed to get a grip on the crisis. Everyone understands that we are in the midst of a global pandemic that has placed the NHS under unprecedented pressure, but that does not excuse or explain why we went into the pandemic with NHS waiting lists at record levels and with unprecedented staff shortages.

Ministers want people to believe that the winter crisis is simply the result of the challenges of covid, but in reality, the entire health and social care system has been left dangerously exposed by their choices throughout the last 11 years. Before the pandemic, there were waiting lists of 4.5 million, staff shortages of 100,000 and social care vacancies of 112,000. This week, the National Audit Office detailed starkly that things are set to get even worse, with waiting lists set to double in three years.

Ministers cannot possibly believe that what we have been given today is a credible plan to meet those enormous challenges. If it were a genuine plan to prepare for the winter, why has it arrived on 3 December? A serious plan to bring down waiting lists would have the workforce at its heart, and would have clear targets and deadlines. A serious plan would recognise that, unless we focus on prevention, early intervention and fixing the social care crisis, Ministers have no chance of bringing waiting lists down to the record low levels we saw under the last Labour Government.

That Government had a serious plan to reduce waiting lists with 45,000 more doctors, 89,000 more nurses and the biggest hospital-building programme in our country’s history. The programme of investment, reform and clear targets delivered a decrease in waiting times from 18 months to 18 weeks. Although bricks and mortar and technology are important, and we do not sniff at the investment the Minister has outlined, the central challenge of the NHS winter crisis is a shortage of professional staff.

A credible plan to tackle the NHS winter crisis, which was foreseeable and foreseen, would have been published long before 3 December. Without a serious strategy to build the health and social care workforce that we need, this plan is not a plan at all.

[Edward Argar]

I join the shadow Secretary of State in paying tribute to his predecessor, the right hon. Member for Leicester South (Jonathan Ashworth), who is my near neighbour in Leicestershire. Although we may have occasionally crossed swords across the Dispatch Box, he is a deeply honourable and decent man. I also take the opportunity to pay tribute to the hon. Member for Leicester West (Liz Kendall), who is planning to take maternity leave in due course. She is a doughty champion for social care and the sector. I know that she will be much missed in her time away from the Dispatch Box.

I genuinely congratulate the hon. Member for Ilford North (Wes Streeting) on his post, although after that response, I do so with a degree of trepidation about what we might have in store for us in the months ahead from him challenging us—quite rightly. He is extremely diligent in all the roles he performs, so I welcome him to a challenging but fantastic role.

I will be relatively brief in my answers, because I am conscious that Fridays are for private Members’ Bills and private Members’ speeches. We brought the statement to the House because we believe it is important, given that it is going to the media, that we give the House an opportunity to question it.

The shadow Secretary of State was right to pay tribute to the workforce—the social care workforce and the health workforce, as well as all the other key workers who have helped get us to where we are in this pandemic. The workforce are the golden thread that runs through our NHS and through social care. Buildings and technology are important, but they are, essentially, the tools that the workforce use to provide that vital patient care.

We have a clear plan not only for winter, but for the recovery of waiting list times and for driving down those waiting lists. Ours is the party that has given the NHS record funding. Even before the pandemic, we put the £33.9 billion increase into law: we said we would do it, and we did do it. We are backing our NHS to give it the tools that it needs.

One issue on which I agreed with the hon. Gentleman is prevention. He is right: we need to look not only at the symptoms and the consequences in treating people, but at prevention of long-term and serious illness. He was also right in what he said about fixing social care, but I would urge a bit of caution. In 13 years we had two Green Papers, one royal commission and the 2008 spending review, all of which were designed to fix the social care problem. Result: nothing. This Government said they would come forward with a plan, and have come forward with a clear and coherent plan. I pay tribute to the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), and indeed to her predecessor, my hon. Friend the Member for Faversham and Mid Kent (Helen Whately), for the work that they have done in grappling with this very challenging issue.

The hon. Gentleman mentioned hospital buildings. Again, he was right: we are building 40 new hospitals. I would, however, say to him and to other Opposition Members that they should be very careful when talking about this subject. We all know that one of the biggest challenges we face with capital in our NHS is the millstone of PFI debt around the necks of NHS trusts—private finance initiative programmes put in place under the last Labour Government. We are still paying for that.

I welcome the hon. Gentleman to his post, and I suspect that on many occasions in the future we will have further such exchanges across the Dispatch Boxes. I am sorry that on his first outing in his new role he is facing me rather than the Secretary of State, but it is a pleasure to be opposite him.

[Wes Streeting]

We’ve been given the best.

[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.