NHS Funding Bill

Baroness Laing of Elderslie Excerpts

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

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

As well as the question of what the money will be spent on—and I welcome the extra investment—there is the question of—[Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. There is a separate Scottish debate going on, and, however interesting it might be, it is not good if I can hear that and cannot hear the hon. Lady.

[Debbie Abrahams]

I could not hear myself, Madam Deputy Speaker.

It is also a question of who and where. We know that life expectancy is flatlining, that healthy life expectancy is flatlining, and that in some parts of the country, including the north-west, it is actually going backwards. How are we to ensure that we target the money where it is most needed?

--- Later in debate ---

[Siobhain McDonagh]

Is my hon. Friend aware that there is also a tendency for capital funding in new schemes to go to those areas that are far more wealthy than those with the greatest health inequalities? Let me give my own experience of Epsom and Saint Helier Trust, where the local NHS is consulting on moving all acute services to Belmont.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The hon. Lady will have her chance to speak for quite some time later in the debate, and I think that the hon. Gentleman is just concluding his speech.

[Jonathan Ashworth]

My hon. Friend’s point is absolutely right, and she is right to raise it.

The point is this: those most in need of health services now experience the poorest quality of care. It is an absolute disgrace. This political stunt of an underfunding Bill will not deliver the scale of improvements that our constituents deserve. We will not divide the House tonight, but instead seek to amend the Bill. Let us be clear: the Government should have brought forward a fully funded financial settlement for our NHS and social care. The ever lengthening queues of the sick and elderly in our constituencies deserve so much better.

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. It will be obvious to the House that a great many people wish to speak this evening and that there is limited time. We will begin with an immediate time limit of nine minutes, but I give notice that that is likely to be reduced later in the evening. I also point out to new Members that, because the time limit is nine minutes, it is not required that they take up the whole of the nine minutes. Brevity is, and always will be, the soul of wit.

NHS Funding Bill

Baroness Laing of Elderslie Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Alex Cunningham]

You, Dame Eleanor, were not in the Chamber when the hon. Member for Glasgow North (Patrick Grady) indicated that SNP Members might pass through the Lobby, although of course they will not be counted. I seek your help. I want to make sure that the Government Whips do not get confused by my accent and count my vote on behalf of the people of Stockton North when I support the amendment.

[The Chairman of Ways and Means (Dame Eleanor Laing)]

The hon. Gentleman asks for clarification and raises a point that I have many times had cause to raise myself, so I am in total sympathy with him, and I am quite sure that his plea has been heard.

[Alex Cunningham]

I am very grateful, Madam Deputy Speaker.

Amendment 2 concerns spending on mental health services and the Secretary of State’s plans to achieve parity of esteem. Mental illness is often not viewed as a risk to human life, but it is exactly that. In 2018, according to the Samaritans, 6,507 deaths in the United Kingdom were registered as suicides—an increase of 10.9% on the previous year. That means that nearly 7,000 people did not believe that there was help, or another way out of what they were going through.

It can be hard for adults to talk about the feelings that come from being mentally unwell. The words are in their vocabulary, and it may be simple enough to string them together into a sentence, but it is incredibly difficult to say them out loud. I can only imagine how hard it must be for children to express how they are feeling when something is not right. Perhaps they do say the words that are in their heads, but they are not taken seriously. It is a scandal that there are suicidal children as young as 12 who are having to wait more than two weeks for a mental health bed. By not viewing mental illness as life-threatening, we are letting generations down.

There is much debate about what causes mental illness and what is the best form of treatment, but it can take several visits to a GP for people to be taken seriously about not being OK—although many GPs, of course, respond immediately. When parents are fighting for their unwell children to be taken seriously and receive the urgent care and treatment they need, it is horrifying for that to be delayed.

At this stage I should pay tribute to my former colleague Paul Williams, who was the Member of Parliament for Stockton South. He is a GP, and as a member of the Health Committee he spoke extensively about health matters, but locally he took on the child and adolescent mental health services. He knew, as I did because we shared the same area, that it was taking well over two years for young people to be seen by CAMHS. As a direct result of his work, that ended, up to a point, because some children who were due to be seen quickly were actually seen when they should have been. However, those long waits still exist in our area. As we heard earlier from the right hon. Member for South West Surrey (Jeremy Hunt), the former Health Secretary, sometimes children are just not taken seriously.

It is right for the Secretary of State to answer to the House on exactly what the Department is doing, because this is a matter of life and death. Not only the House but the country needs assurance and answers. The state of mental health services will only get worse unless we take action to deliver what is required. The additional money is more than welcome, but I see the amendment as the first, necessary step to provide the funds that are so desperately needed. Equally important is the ability to monitor what those funds are being spent on, and how.

There are many other services on which people depend heavily, including some that we may take for granted, such as smoking cessation services. There is widespread concern about existing funding for services to help people stop smoking. Nearly a third of local authorities no longer provide specialist “stop smoking” services. Stopping smoking is not just a matter of nicotine patches or vaping; people need behavioural support as well, particularly pregnant women, children, and people who are already unwell. One ward in my constituency has some of the highest incidences of smoking in families—whole families smoking—but we also have some of the highest incidences of smoking during pregnancy, and that is not good for the unborn child.

We cannot afford to lose the progress that we have made. We have made tremendous progress over the years, but we need local services that are effective and properly funded. The Government also need to return to funding the multi-media approach to smoking cessation services. I was particularly pleased to learn last week that research has shown that the ban on smoking in cars when a child is present has produced a 75% drop in children being exposed to cigarette smoke in a car. I led on that issue during my first few years as an MP, through private Members’ Bills and a ten-minute rule Bill. The Bills were unsuccessful, but I was delighted when the Government adopted my clause a few years later. We still need to be ambitious and bold about helping people to quit smoking, but services need the resources. I hope the Minister will commit to ensuring that such services are provided, whether for mental health or for smoking cessation, and that they are fully funded so that we can continue to make real progress in that area.

Finally, I shall turn to the matter of capital. The Minister has already heard me talk about the needs in my own constituency. In one ward—the same one I referred to earlier: the Town Centre ward in Stockton—men live 14 years less than those in the Prime Minister’s constituency. His constituency is getting a new hospital, but there are no plans yet for us. However, I have good news for the Minister, because the plan for our hospital is still sitting there. I met the chief executive of North Tees and Hartlepool NHS Foundation Trust just two weeks ago, and she told me that they were ready to dust off the plans again and see how we could provide a hospital. At the time we asked for £100 million from the Government as a guarantor in order to make the project work. The numbers do work, and the health inequalities need to be addressed.

We need to be able to attract the best doctors and clinicians that we can to address the problems in our society. The heart problems are higher on average than anywhere else in the country. We have smoking problems, as I have mentioned, with their related lung and respiratory problems. We also have the legacy of our heavy industry on Teesside, where men who have now retired are in extremely ill health but sometimes cannot get the support they need because we do not have the experts locally to provide it.

In my final sentences, I appeal to the Minister to meet me and the trust members so that we can sit down and talk about this project.

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[Patrick Grady (Glasgow North) (SNP)]

On a point of order, Dame Eleanor. I notice that it is now 5.10 pm and that the Minister is about to get to his feet. If the knife falls at 5.30 pm, while the Minister is still speaking, or a Division is under way, can you confirm that that means there will be no Report stage, and no chance for the SNP amendments to be tabled or voted on?

[The Chairman of Ways and Means (Dame Eleanor Laing)]

The hon. Gentleman is absolutely right in regard to the procedure. If we finish this part of the procedure before 5.29 pm, there will be a very short time for the next part of the procedure. If this part of the consideration of the Bill goes to 5.29 pm, there will indeed be no time for the Report and consideration stage. That is correct, as is normal in any Bill, but I am grateful to him for pointing it out so clearly.

[Edward Argar]

In the 15 or so minutes remaining to me, I will endeavour to address all the points that have been raised. First, I thank Members on both sides of the House for their contributions and for the amendments that have been tabled. I particularly thank the shadow Minister for his typically reasonable tone in making his case forcefully. This Committee debate has been a wide-ranging and important one.

I will turn in detail to the amendments shortly, but, in the interests of time, I will swiftly address the requests for meetings or visits. The hon. Member for Stockton North (Alex Cunningham) was right when he said that he saw me nodding. I will be very happy to meet him, my hon. Friend the Member for Stockton South (Matt Vickers) and the chief executive of his hospital trust to discuss the issues that he raised. I will also be very happy to meet the hon. Member for Harrow West (Gareth Thomas) separately to discuss the issues that he raised.

--- Later in debate ---

Three hours having elapsed since the commencement of proceedings, the debate was interrupted (Programme Order, 27 January).

[The Chairman of Ways and Means (Dame Eleanor Laing)]

Under the programme order of 27 January, I must now put the Questions necessary to dispose of the proceedings in the Legislative Grand Committee (England) on the Committee stage of the Bill, and on the consideration —Report—stage and the consent motion in the Legislative Grand Committee (England). I can see some puzzled faces around the Chamber, and not only among those who have newly been elected to this place, so for the sake of Members unfamiliar with our procedures in respect of Legislative Grand Committees, I will set out what is about to happen.

I will put the Question on amendment 2, which has already been proposed from the Chair. I will then call a member of the Legislative Grand Committee (England) to move amendment 3 to clause 1. When he has done so, I will put the Question on that amendment. I will then put the single Question that clause 1—or clause 1, as amended, if it has been so amended—and clause 2 stand part of the Bill. I will then call a member of the Legislative Grand Committee (England) to move new clause 4. When he has done so, I will put the Question that the new clause be added to the Bill.

[Pete Wishart]

Can you read it again?

[The Chairman]

I could, but we might get to the stage where there are no votes at all.

When the proceedings in the Legislative Grand Committee (England) on the Committee stage of the Bill are concluded, I will resume the Speaker’s Chair for the Whip to report the Bill from Committee. As the three-hour knife has now fallen, there are no amendments for consideration on Report, as the hon. Member for Glasgow North (Patrick Grady) rightly pointed out in his point of order earlier.

The House will again resolve itself into the Legislative Grand Committee (England) to give consent to the Bill as a whole. I will call the Minister to move the consent motion formally, and I will put the Question on the consent motion forthwith. I can see that everybody understands this a lot better now. When the proceedings in the Legislative Grand Committee (England) on the consent motion are concluded, I will resume the Speaker’s Chair and call the Minister to move the Third Reading of the Bill.

I remind hon. Members that, if there is a Division in the Legislative Grand Committee, only Members representing constituencies in England may vote. All Members may vote on the Third Reading of the Bill.

[Pete Wishart]

On a point of order, Dame Eleanor. I am very sorry, but although I was listening very carefully, I did not quite catch all of that. Do you mind repeating it once again, please?

[The Chairman]

I fully appreciate that the hon. Gentleman may not have caught all of that, but I happen to know that he is one of a handful of people in this House who does actually understand this procedure. I hope that I am one of the others, and everyone else will pick it up as we go along.

The Chair put forthwith the Question already proposed from the Chair (Standing Order No. 83D), That amendment 2 be made.

The Committee having proceeded to a Division.

[The Chairman]

Will the Serjeant at Arms please investigate the delay in the Aye Lobby?

--- Later in debate ---

[Patrick Grady]

On a point of order, Dame Eleanor. I think that we should mark this moment. This is the busiest that the English Parliament has been since 1707. I have never seen so many people so keen to take part.

I am interested in the numbers that have just been read out, Madam Deputy Speaker, because 163 for the Ayes seems very low to me. Just by means of a headcount, I counted a significant number more than that. In fact, according to my calculations, at least 46 Members from Scotland, Wales and Northern Ireland were in the Lobby just now. Can you tell me whether the number that was read out in the House accurately records the number of Members of Parliament who wished to express their view on the amendment?

[The Chairman of Ways and Means (Dame Eleanor Laing)]

I am grateful to the hon. Gentleman for expressing his concerns in such an articulate fashion, and I note the words that he has used. I can confirm to him that, although his count of the number of Members who wished to express their view might well be correct, the numbers that I have announced to the House and on which I will rely from the Chair constitute the number of Members who have a right to vote on this matter. As the hon. Gentleman knows, under the procedures set out in Standing Order 83W—with which he, if not the rest of the House, must of course be familiar—Members who do not represent constituencies geographically situated in England do not have a right to vote in these particular Divisions.

[Ian Blackford (Ross, Skye and Lochaber) (SNP)]

On a point of order, Dame Eleanor. Perhaps you can enlighten me. Is this indeed the first time that Members from Scotland have had their votes discounted in this place? What conclusion should we draw, Madam Deputy Speaker, when an item such as this Bill will have spending consequences for Scotland, and yet Scottish MPs are locked out of this place? Can we not draw our own conclusion that this is indeed the English Parliament? The answer to the people of Scotland is very clear: if you want your votes to be counted, we had better become an independent Parliament in Scotland.

[The Chairman]

I am afraid that the right hon. Gentleman does not quite explain the situation as it really is. You see, this Parliament, as the Parliament of the United Kingdom, passed certain rules some time ago, and it is not correct to say that Members from Scottish constituencies are locked out; far from it. Members from Scottish constituencies, and constituencies in every part of the United Kingdom, have not been locked out. They have been allowed to participate in the debate, but not to vote in it. Members from Northern Ireland constituencies and from Welsh constituencies are similarly categorised for the purpose of these particular Divisions.

[The Chancellor of the Duchy of Lancaster (Michael Gove)]

Further to that point of order, Dame Eleanor. Is it not the case that health is a devolved matter, and that the NHS in Scotland is the responsibility of the Scottish Parliament? Is it not the case that, therefore, Members of this House have no votes on, or say in, what happens in the NHS in Scotland, and is it not appropriate to point out to SNP Members that while they stage these stunts here, the Royal Hospital for Sick Children in Edinburgh, for which they are responsible, remains closed, and cases of poisoning in hospitals in Glasgow for which they are responsible remain undealt with? Until the Scottish Government make sure that the health of the people of Scotland is looked after, the people of Scotland will regard this as a transparent stunt on the part of people who, instead of representing their constituents, seek to manufacture grievance.

[The Chairman]

I fully appreciate the point—[Interruption.] Order. This will not degenerate into a shouting match.

The right hon. Gentleman has expressed his view with his usual rhetorical flourish. My only comment must be that this is a very narrow Bill, specifically making provision for the funding of the health service in England. I have to go with what it says on the Bill, and it is therefore correct for it to be administered in this way.

[Martin Docherty-Hughes (West Dunbartonshire) (SNP)]

On a point of order, Dame Eleanor. I have due regard for your judgments. When I first rose to speak in the House in 2015, I said to the then Speaker that, while I was no Unionist or home ruler, I would stand shoulder to shoulder in defending the role of the Speaker. My concern, if this is the Parliament of the United Kingdom of Great Britain and Northern Ireland, is that this Bill has Barnett consequentials for the nation of Scotland, the nation of Wales and the communities of Northern Ireland. Therefore, I am gravely concerned that the EVEL system is being used to exclude the notion that there are Barnett consequentials. You may wish to clarify this for the Members of the Conservative and Unionist one nation party.

[The Chairman]

I fully appreciate the point that the hon. Gentleman raises, and there may well be Barnett consequentials—[Hon. Members: “Ah!”] There may be further opportunities when further legislation about these matters comes before the House, but this particular Bill is a very narrow one, and therefore the ruling is quite clear. I appreciate what the hon. Gentleman says about protecting the Chair and rulings from the Chair. In this case, there is no grey area. Under Standing Order No. 83W, no matter who passes through the Division Lobby in these three Divisions before us—or however many Divisions there might be—only the votes of Members sitting for English constituencies will be counted.

[Mrs Maria Miller (Basingstoke) (Con)]

On a point of order, Dame Eleanor. I know that Mr Speaker has strict rules about the use of promotional material in the Chamber of the House of Commons, and I am sure that, quite unintentionally, some Members might be displaying material that perhaps would be inappropriate. Will you point out that there are strict rules on that, and that it should not be done in the way that it has been done?

[The Chairman]

I am grateful to the right hon. Lady. I must say to her and to the Committee that I was hoping that I would not see any promotional materials—[Interruption.] Oh no! I see one! I was hoping that such an occurrence would not happen right now. No promotional materials should ever be displayed in the Chamber. For the avoidance of doubt, I refer hon. Members to paragraph 21.29 of “Erskine May”—Mr Blackford, you will like this one—which states clearly that

“all Members should be sufficiently articulate to express what they want to say without diagrams”.

I will now proceed to amendment 3 to clause 1, which I have selected for a separate decision.

The Chair then put forthwith the Questions necessary for the disposal of the business to be concluded at that time (Standing Order No. 83D).

Amendment proposed: 3, in clause 1, page 1, line 18, at end insert—

“and that the sums set out in the table are not permitted to be augmented by or composed of any virements from NHS capital budgets.”—(Justin Madders.)

The amendment would stop the Secretary of State meeting the NHS England allotment for resource spending by using funds from NHS capital budgets.

The Committee proceeded to a Division.

[The Chairman]

I ask the Serjeant at Arms to investigate the delay in the Aye Lobby.

--- Later in debate ---

[Madam Deputy Speaker (Dame Eleanor Laing)]

There are no amendments on consideration.

[Patrick Grady]

On a point of order, Madam Deputy Speaker. It is great to be back in the United Kingdom Parliament—just like magic! I congratulate you on your skilful chairing of the English Parliament from the lower Chair over the last three hours. You have just announced that there are no amendments to be considered on Report as none had been tabled because the knife fell more than an hour ago. Could you confirm that that is correct? I notice that the selection list says:

“Mr Speaker has provisionally selected…New Clauses…as long as the 3 hour time limit has not expired: NC6 [SNP] + NC7 [SNP].”

For the record, can we confirm that the effect of all this has been that amendments tabled by Members of the Scottish National party have not been debated tonight and could not been divided on because the Government did not provide enough time, or Members took up so much time in the meeting of the English Parliament—the Legislative Grand Committee—that they have effectively denied the rights of SNP Members to table amendments to a Bill that directly affects our constituents?

[Madam Deputy Speaker]

The hon. Gentleman’s analysis is not wrong. The knife has fallen. The House voted some days ago to provide three hours, or four hours in total, for consideration of this Bill, and it is indeed the case that because those four hours have passed, there is no time for debate on consideration and Report—that is absolutely correct. There is also no time for debate on Third Reading.

As to whether the Government did not provide sufficient time, or Members of this House took up all the time in the early part of the proceedings, that is not a matter for me to judge; I have merely facilitated it. Members might have decided not to speak for very long at the beginning. If so, the hon. Gentleman and his colleagues would have had the opportunity to discuss the matters that they had tabled. I thank him for his further points.

Does the Minister intend to move a consent motion in the Legislative Grand Committee?

[Edward Argar]

indicated assent.

The House forthwith resolved itself into the Legislative Grand Committee (England) (Standing Order No. 83M(3)).

[Dame Eleanor Laing in the Chair]

[The Chairman of Ways and Means (Dame Eleanor Laing)]

I remind hon. Members, although I do not think there is any need for reminding at this stage, that if there is a Division, only Members representing constituencies in England may vote.

[Patrick Grady]

On a point of order, Dame Eleanor. We are back in the English Parliament again and the absurdity of this procedure is now being laid bare. [Interruption.] I am delighted that Conservative Members are groaning because several of them voted for it when it was introduced way back in 2015. They did not have to—it was a choice. I am not trying to beat the record of my hon. Friend the Member for Perth and North Perthshire (Pete Wishart), who has spoken in the Legislative Grand Committee for England more times than any other Member of this House over the past four years, but can we just confirm again that, as you said, if Scottish Members, for whatever reason, were to object to the consent motion, you would not even be able to hear their voices —it is as if we are invisible?

[The Chairman]

It is not as if any hon. Member of this House is ever invisible or, indeed, inaudible, but merely, once again, following Standing Order No. 83W, which this House resolved to put into the Standing Orders of the House.

[Pete Wishart]

On a point of order, Dame Eleanor. [Interruption.] I hear the groans from my Conservative colleagues. I have to keep my record of speaking in the English Parliament—it is a record that I very much cherish and look forward to maintaining. These events are being televised and people throughout the United Kingdom, particularly those in Scotland, are observing our proceedings with a degree of mystification and bewilderment. What Scottish viewers will see is the baying, groaning and booing of Conservative Members about Scottish Members of Parliament asserting their rights to have their say on the funding of the national health service. Can you confirm that that is the case and that this House really needs to grow up, behave itself and come into the 21st century?

[The Chairman]

I understand the point that the hon. Gentleman makes. I would say, as Mr Speaker always says, and as every occupant of the Chair always says, that our behaviour in this Chamber should, at all times, be of a standard that makes us never ashamed to be watched by anyone on television or in any other way, regardless of the subject of our proceedings. I notice that that has engendered some slightly better behaviour—thank you.

Motion made, and Question put forthwith,

That the Legislative Grand Committee (England) consents to the NHS Funding Bill, not amended in the Legislative Grand Committee (England).— (Edward Argar.)

Under the terms of the Order of the House of 27 January, I must now put the Question necessary to bring to a conclusion the proceedings in the Legislative Grand Committee on the consent motion. The question is the consent motion. As many are of that opinion say “Aye”—[Hon. Members: “Aye!”]—of the contrary “No”—[Hon. Members: “No!”]. The Ayes have it—[Interruption.] We now come to a scientific matter. Members representing Scottish seats are well aware that they do not have the right to vote on this particular motion. They therefore do not have the right to shout “No” when I put the question. I can hear “Aye” from the Government Benches. The hon. Member for Perth and North Perthshire (Pete Wishart) knows that I am more than capable of discerning a Scottish “No” from a non-Scottish “No”—[Interruption.] Order. I am ruling that the shouting of “No” from the SNP Benches does not mean that we are going to have a Division.

Question agreed to.

[Martin Docherty-Hughes]

On a point of order, Dame Eleanor. I always have due regard for you and anyone who sits in the Chair of any Parliament. You said that you could discern Scottish MPs shouting “No”; I fully understand that. Can you advise me whether you can hear Scottish constituency MPs on the Government Benches shouting “Aye”?

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[The Chairman]

I believe I can, but as their voices have been drowned out by the English “Ayes”, I cannot hear the Scottish Members on the Government Benches. [Interruption.] The hon. Member for Milton Keynes South (Iain Stewart) points out that, although he has a Scottish voice, he has an English vote. We have had enough of this.

[Ian Blackford]

On a point of order, Dame Eleanor. I am grateful to you for allowing this point of order. I wonder whether you can help me. When we were all elected to this place in December 2019, we were sent here to represent our constituents. What message does it give to the people of Ross, Skye and Lochaber and the constituents of my many hon. Friends that we are not permitted to vote on matters in this House that have direct consequences for spending in Scotland?

[The Chairman]

That is not a point of order for the Chair, and my opinion on the matter is irrelevant. We have had enough points of order; it is time to continue with business.

The occupant of the Chair left the Chair to report the decision of the Committee (Standing Order No. 83M(6)).

The Deputy Speaker resumed the Chair; decision reported.