Health and Care Bill

Debate between Iain Duncan Smith and Edward Argar

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Edward Argar]

As ever, the hon. Lady makes her point courteously but clearly. As I said, depending on the time available at the end of the debate, I will endeavour to respond more fully to the points that she and my right hon. Friend make.

[Sir Iain Duncan Smith (Chingford and Woodford Green) (Con)]

I hope to speak on this subject if I catch your eye, Madam Deputy Speaker, but I want to make the point that right now, even though it is not meant to be allowed, the NHS is using products made by slave labour. Only two days ago, The Spectator demonstrated that products being used in King’s College Hospital actually came from providers in Xinjiang, so it is happening now. Like the hon. Member for Lewisham East, I want to emphasise the urgency of this issue, so I intend to bring it up with my hon. Friend the Minister during the debate.

[Edward Argar]

I should say at this point that I was grateful for the opportunity to talk to my right hon. Friend about this subject a week or two ago, and I suspect that our conversations will continue.

I want to cover the rest of this group of amendments. Lords amendment 57 would exclude statutory functions of NHS Digital from the transfer of powers in the Bill. I urge the House to reject that amendment. I have assured Members of this House and in the other place that the proposed transfer of functions of NHS Digital to NHS England would not in any way weaken the safeguards we have in place for the safe and appropriate use of patient data. NHS Digital’s current obligations in terms of its data functions, and particularly the safeguards that apply to patient data, will become obligations on NHS England. The merger, which has been announced as Government policy, is in response to the recommendation of the Wade-Gery review. It is essential to simplify a complex picture of national responsibilities for digital and data services in the NHS, bringing them together in a single organisation that leads on delivery and the data needed to support it.

--- Later in debate ---

[Edward Argar]

As ever, I thank hon. and right hon. Members from all parts of the House for all their contributions to this important debate on an important set of amendments. Even if I do not always agree with everything he says, I welcome in particular the contribution from the hon. Member for Ellesmere Port and Neston (Justin Madders). He and I spent a productive period—I was going to say happy—sitting opposite one another for two days a week over many weeks in Bill Committee, taking this legislation through. While I miss him from his previous role as effectively my shadow, I wish him well in his current shadow ministerial role. I also put on record my gratitude, although he cannot be here today, to the hon. Member for Nottingham North (Alex Norris) for his work on the Bill.

I gently tease, and this is no reflection on the current shadow Minister, that in Committee it took two shadow Ministers to try to keep me on my toes. It appears today that it takes three, but in saying that I cast no aspersions on the shadow Secretary of State, the hon. Member for Ilford North (Wes Streeting), who I am fond of, even when he is gently or less so gently pushing me on certain issues.

I turn first to the organ tourism amendment, and I am grateful to the shadow Secretary of State for his approach on this issue. We have a shared objective here, and I assure Members that our approach would target not only transplant tourists, but anyone involved in making the arrangements for the purchase of the organ who may be a British national. The Government amendment, paired with our commitment to work with NHS Blood and Transplant to make more patients aware of the legal, health, and ethical ramifications of purchasing an organ, will send an unambiguous signal that complicity in the abuses associated with the overseas organ trade will not be tolerated.

Turning to reconfigurations, I strongly believe that the public rightly expect Ministers to be accountable for the health service, which includes the reconfigurations of NHS services. This House rightly voted to retain these clauses on Report. The reconfiguration power will ensure that decisions made in the NHS that affect all our constituents are subject to democratic oversight. Without it, the Secretary of State’s ability to intervene and take decisions will remain limited, and usually be at a very late stage in the process. Although I hear what hon. Members have said, I note that many hon. Members from both sides of the House none the less seek to persuade the Secretary of State and seek to raise issues relating to their local services with the Secretary of State with a particular outcome in mind.

As now, the Secretary of State would not be alerted to a potential change in services until the change had become a relevant issue and would not be able to intervene without that formal referral. We have retained the independent reconfiguration panel. The shadow Secretary of State raised the issue of the clinical appropriateness of the changes. Nothing that is proposed here alters the fact that clinical appropriateness and clinical and patient safety remain central to any decisions and remain an obligation on the Secretary of State in any decisions that he or she makes in that context.

Briefly, on the remarks of the shadow Secretary of State about waiting lists, he will be aware that we published a comprehensive and ambitious but realistic elective recovery plan that is backed by record funding and resources for the NHS to tackle those waiting lists, which have grown as a result of the pandemic. I am straight enough with him to recognise that there were waiting lists before the pandemic. He always makes that point and I highlight that we have a plan to fix that, which is exactly what we are doing.

The shadow Secretary of State also highlighted several other factors relating to the workforce and the workforce clause, as did my right hon. Friend the Member for South West Surrey (Jeremy Hunt), the shadow Secretary of State—sorry, the Chair of the Health and Social Care Committee; I do not think we will be fielding shadow Secretaries of State from the Conservative Benches for some time yet. I entirely understand where my right hon. Friend is coming from on this issue, but I believe the approach that the Government have adopted, with the framework 15 commission and review and the broader commission that the Secretary of State has set out to look at drivers of workforce supply and demand, absolutely reflects our recognition of the centrality and importance of the workforce, and the right workforce, to the delivery of all our ambitions for constituents and for recovering waiting lists and waiting times.

We have not waited for any projections to get on with that; we are already investing in increasing our workforce and we are seeing record numbers of people working in our NHS. I have already highlighted that we are well on target to meet the commitment of 50,000 more nurses, with a current increase in the number of nurses of 27,000. The hon. Member for St Albans (Daisy Cooper) highlighted the same issues in her remarks.

I am particularly grateful to my right hon. Friend the Member for Chingford and Woodford Green (Sir Iain Duncan Smith) for his contribution on a challenging issue. There is a considerable degree of consensus on both sides of the House about the abhorrence of modern slavery, slavery or anything linked to it. We remain of the view that this is not the right legislation for the proposed changes.

As I set out in my previous remarks, new rules for transforming public procurement will further strengthen the ability of public sector bodies to exclude suppliers from bidding for contracts where they have a history of misconduct—or extreme misconduct in the case of slavery, forced labour or similar. In developing the modern slavery strategy review, it will continue to be important to engage across Government and civil society, nationally and internationally, to collect the necessary evidence to agree an ambitious set of objectives. It is right that the Government take action on the crime of modern slavery and it is right that the NHS is in step with all public bodies in doing so.

From listening to my right hon. Friend, I expect the issue to reappear when their lordships consider our amendments. In that context, I hope that he and other hon. Members are willing to continue to engage with the Government and my Department on this hugely important issue. As he rightly said, it is important not just in this House but outside this House to those we represent. I look forward to continued engagement with him.

[Sir Iain Duncan Smith]

Will the Minister give way?

[Edward Argar]

I have literally 30 seconds left, so if my right hon. Friend’s intervention can be in five seconds, I will give way.

[Sir Iain Duncan Smith]

Can the Minister tell his colleagues in the Government that there is never a good time? Now is the right time, and let us get on with it.

[Edward Argar]

I think that was exactly five seconds, and I am grateful to my right hon. Friend. I suspect that colleagues across Government will have heard what he said and will pay very careful attention to it, as I know Ministers across Government do to all that my right hon. Friend says in this House.

With that in mind, I ask the House to accept the motions in my name on the amendment paper.

Social Distancing: 2 Metre Rule

Debate between Iain Duncan Smith and Edward Argar

Monday 15th June 2020 Commons Chamber

[Edward Argar]

I am grateful to the shadow Minister, as always, for his remarks and for, as ever, the constructive tone that he adopts on these occasions. I share his view that we do want to see the United Kingdom reopening for business, but we want to see it do so in a way that is safe for those going out and shopping—and I encourage people to go out and frequent their shops from today. I also want to ensure that when we are able to safely open hospitality again, we get it going and do so in a safe way based upon the evidence.

On timescales, as my right hon. Friend the Member for Tunbridge Wells (Greg Clark), the Chair of the Select Committee, and the shadow Minister have said, we recognise the importance of getting this information and this decision out there as swiftly as possible, because it is important to give businesses all the time we can to prepare for it. Equally, however, the shadow Minister would not expect me to set a particular deadline while the work is being done. I have said that that will be within a matter of weeks and that we recognise the urgency for business, but it is important that those conducting the review can do so properly and rigorously, so that it is useful for the decision we have to make. Once that review has reported and the Prime Minister has had the opportunity to consider it, I would, of course, expect the findings to be made public.

On the WHO’s comments, the hon. Gentleman is absolutely right to highlight that the 2 metre distance is only one part of the measures—only part of the complex package that is in place to reduce risk and to protect public health. As we have seen, different countries around the world have adopted different approaches, such as on whether to reduce the distance and have imposed different requirements on the wearing of face masks. Therefore, there is, in a sense, a menu of different options all of which can reduce risk, and the question is how to come up with the most appropriate balance between reducing risk while also opening up business. On the Committee we see economists and clinical and scientific expertise feeding into that balance-picture. As the Chancellor said at the weekend, it is not binary; we must consider this in the round, considering all relevant factors.

The hon. Gentleman mentioned test and trace. It is a hugely important part of the armoury of options to chase down this disease and allow our economy to reopen. As he will have seen last week, we made a very good start in the first week of the operation of the new test and trace system. We also saw a very, very high willingness on behalf of members of the public to self-isolate when asked to do so, and I pay tribute to everyone who has done that and thank them for doing so.

Finally, I say to the hon. Gentleman that I believe that throughout this pandemic we have been learning every day about how the disease behaves, about what is needed to tackle it and what steps are most effective, and I am confident that we have done the right thing at the right time throughout. However, like any responsible Government, of course there will be lessons to learn and it is important that we are willing to learn them.

[Sir Iain Duncan Smith (Chingford and Woodford Green) (Con)]

I congratulate my right hon. Friend the Member for Tunbridge Wells (Greg Clark) on securing this urgent question, because this is the most important and significant strategic decision the Government are going to have to make as they unlock the economy. The problem is that so much of this debate has been shaped around the idea of the economy as an economic tool, but it is not just economic. The reality is that, with our focus on covid, we are in danger of losing sight of what will happen, probably to the poorest in society, if people start to fall unemployed and suffer depression and increased illness. This will have a major effect on the ability of people to be able to manage their lives. So this is not just economic. It could be six weeks before we discover the outcome of a review, but I do not believe that a single fact is going to change in that six weeks. The reality is that the advisers are all divided; the Government must make a decision and get this one right.

[Edward Argar]

I am grateful to my right hon. Friend. I have huge respect for him and for his campaigning on this issue, particularly in the context of the extraordinary work he has done on social justice over many years. He highlights the importance of looking at the impact of covid-19, not just in the immediate context of health outcomes, but at its broader social and economic impact. He is absolutely right. He is also right to emphasise the need for urgency, and that is exactly how we will conduct this review.

On his final point, he is right: the science is mixed. There are different scientific opinions, and a balance must be struck between the best scientific advice and consideration of the impact on the economy. As a great former Prime Minister once said:

“Advisers advise, and Ministers decide.”

Children’s Funeral Fund

Debate between Iain Duncan Smith and Edward Argar

Wednesday 1st May 2019 Commons Chamber

[Edward Argar]

I want to give at this Dispatch Box a very clear and succinct answer: I agree entirely with the point that the hon. Lady makes. I will come on in a moment to what I have been doing to take a close and personal interest in making sure that this is driven at pace.

[Mr Duncan Smith]

I mean my hon. Friend no criticism, because I am a huge supporter of his—I think he is doing a great job, as is the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Colchester (Will Quince), who I am incredibly pleased to see on the Front Bench—but I just want to press him slightly on this. Having sat in government for six years and run a Department, I know that when you really want to, you can get these things done—excuse my language, Mr Speaker—pretty damn quickly, so I simply say to him that there may be something else that has been blocking this. If it sits in the Treasury, then I would hope that he might indicate that, because he will find that the pressure on the Treasury should be enormous right now. These are not large numbers in economic terms but they are large in human terms. I simply say to him that if anybody is saying that this is an unjustified cost, I promise him that I will give him every support I can, as I have before, to chase the Treasury on this matter. It should be told: do it now.

[Edward Argar]

I am grateful to my right hon. Friend. He is right to highlight that it is not about numbers; every single individual matters. I am clear that we must deliver on this commitment. This should not and will not be about the money. I hope that all Government Departments—including the Department for Work and Pensions and, I am sure, Her Majesty’s Treasury—will wish to play their full role in ensuring that this is delivered expeditiously and properly.

Since I assumed responsibility for this, my officials have been working hard to develop both the necessary legislative vehicle and a delivery mechanism to ensure that it works on the ground. That has involved detailed discussions with the devolved Administrations, which the hon. Member for Vale of Clwyd (Chris Ruane) asked about, to ensure that we learn from them, that we do not inadvertently create a cross-border gap in provision and that everyone has coverage.

More than that, as I alluded to earlier, this has required close working across Government to ensure that the children’s funeral fund is compatible and works well alongside other state provision and, importantly, that it fully fulfils the vision for the scheme of the Prime Minister and the hon. Member for Swansea East. To reflect that, our intention is that provision should be universal and free at the point of need.

As I mentioned, this work has been complex. However, I want to reassure the House that we are very close to putting the final details in place for all three elements. In response to the point made by the hon. Member for Dulwich and West Norwood (Helen Hayes) and others, I expect and am sure that all Departments will be equally seized of the importance of delivering this, and I reassure her that the priority I attach to this means that I have weekly project meetings with the officials delivering it and receive daily progress updates on each of the outstanding elements, so clear am I in my determination to deliver this.