Leaving the EU: NHS

Debate between John Grogan and Steve Barclay

Thursday 22nd March 2018 Westminster Hall

[Stephen Barclay]

There has been a slight reduction in nurses; the situation is more textured for clinicians as a whole. The hon. Gentleman did not touch on the fact that there are almost twice as many doctors from the rest of the world than from the EU. The NHS recruits internationally, and that will still be the case after Brexit. The Prime Minister has signalled repeatedly that the UK will be open to the brightest and best, and that will continue to be the case regardless of the deal we do.

[John Grogan (Keighley) (Lab)]

Looking to the future, doctors from outside the EU are currently subject to a strict regime, and at the moment the demand for sponsorship certificates showing that an NHS trust wants to employ a doctor seems to exceed the supply. Will doctors from the EU who want to come to our country post Brexit be subject to the same regime, or does the Minister envisage a different regime? What representations is he making to the Home Office about that matter as we look forward to the immigration Bill?

[Stephen Barclay]

Of course we are making representations to the Home Office, but the Prime Minister has signalled our commitment to attracting the brightest and best, and that will continue. What has been negotiated so far probably gives the hon. Gentleman the best signal. What the Prime Minister announced in December and what my right hon. Friend the Secretary of State for Exiting the European Union announced this week about a transition deal actually protects the rights of EU citizens. That underscores the Government’s commitment to ensuring that a positive message is sent to EU staff in the NHS.

--- Later in debate ---

[Stephen Barclay]

The hon. Lady is right to recognise the skills and talent that the Secretary of State brings to this debate as to many others. It is no coincidence that he is the second-longest serving Secretary of State for Health. It would be recognised across the House that it is a demanding job. It is to his great credit that he has been in post for such a period and that he has championed patient safety in the way that he has, which the shadow Minister has generously recognised on occasion.

The Secretary of State’s role in Government was further signalled and underscored by the Prime Minister in the recent reshuffle, when the responsibility for social care was added to the Department. As the debate has reflected, social care, and how we address it from an immigration perspective, and from a training and upskilling perspective, is one of the key legitimate areas of the Brexit debate. We are focused on that in our discussions with the Home Office and others.

The hon. Member for Motherwell and Wishaw (Marion Fellows) picked up on the need for a transition period. That point reflects the fact that the Government are listening and have responded constructively. I know from my previous role in the financial services sector in the City that there is a strong desire for a transitional period. That point was also raised by many in the healthcare sector. It is to the great credit of the Secretary of State for Exiting the European Union that those discussions have been conducted in such a constructive way. There has been a lot of doom-saying and negative commentary—“Nothing will be agreed; it won’t work.”—but he has assiduously stuck to his task. While there are some formal processes still to be completed, significant progress has been made on a transition deal, and there is reasonable consensus that it is constructive.

Several colleagues mentioned the impact of leaving Euratom. I simply remind the House that there is nothing in the Euratom treaty that prevents materials from being exported from an EU member state to countries outside the EU, nor do those materials fall into the category of so-called special fissile material, which is subject to nuclear safeguards. We very much recognise the short half-life of medical radioisotopes and the need for rapid delivery, but again there is much that can be constructively done.

The shadow Minister mentioned subsidiary companies. I do not want to incur your displeasure by straying too far from the subject of Brexit and into subsidiary companies, Mr Davies, but as the shadow Minister raised that point, I feel it is appropriate to address it. He asked what TUPE protections there will be. There are TUPE protections now and the Government have absolutely no intention to change that.

For those who sometimes suggest, as Opposition Members occasionally do, that subsidiary companies within the NHS is a form of privatisation, I merely remind the House that this legislation was passed in 2006 under a Labour Government. I was not in the House at the time, but I do not recall—this may be one for those connoisseurs of Hansard—that it was presented by Labour Ministers as a way of achieving privatisation in the NHS. Subsidiary companies are 100% owned by their parent company, which is the NHS family, so they stay very much within that.

[John Grogan]

Since the Minister has gone in that direction, I ask him again specifically: if it is such a good idea, would it be a good idea for NHS trusts that propose setting up subsidiary companies to publish their business plans so we can see what is happening with that public money?

[Stephen Barclay]

I am a former member of the Public Accounts Committee. The then Chair, the right hon. Member for Barking (Dame Margaret Hodge), would always talk about following the public pound. The National Audit Office has considerable reach in doing that.

My point is that subsidiary companies are within the NHS family. They are 100% owned by the NHS foundation trust that sets them up. They are a better vehicle than the alternative of contracting out, which gives far less grip over how services are provided. The legislation passed by a Labour Government is welcome. We should not re-write history and suggest that legislation that was fine in 2006 should suddenly be presented as privatisation.

That goes to what we sometimes see in the Brexit debate—I will bring this back to the Brexit debate, Mr Davies—in terms of a trade deal with the US. We are sometimes told that a trade deal with the US in a Brexit context is alarming and somehow a threat to the NHS, often by the same people who are very positive about the EU. When TTIP was being debated, the EU lead negotiator said TTIP was not a threat to the NHS.

Oral Answers to Questions

Debate between John Grogan and Steve Barclay

Tuesday 20th March 2018 Commons Chamber

[John Grogan (Keighley) (Lab)]

With a significant amount of public money at stake, should not NHS trusts that are proposing to set up subsidiary companies publish their full business cases?

[Stephen Barclay]

The point is that trusts are 100% owned by the NHS, so any benefit accrued from the subsidiary goes to the NHS, because it is fully owned by the public sector.

NHS Wholly Owned Subsidiary Companies

Debate between John Grogan and Steve Barclay

Tuesday 6th March 2018 Westminster Hall

[Stephen Barclay]

As I set out in my reply to the hon. Lady, the Department has been clear that setting up a subsidiary is not a vehicle to avoid VAT—that is not acceptable. In the autumn, we sent out guidance to make that clear. As a former Treasury Minister myself, I assure her that Treasury Ministers would take a very close interest if they felt that an abuse of VAT was taking place.

The reality is that commissioners and regulators are responsible for ensuring that NHS providers act in the best interests of patients and taxpayers. We would expect providers to work closely with their employees in any developments.

[John Grogan (Keighley) (Lab)]

Will the Minister give way?

[Stephen Barclay]

I am conscious of the time, but I am very keen to take an intervention from the hon. Gentleman.

[John Grogan]

The Minister is being very generous. Clearly there is a substantial difference of view here, but would he agree that given that public money is involved, it is very much in the public interest that the business plans that the trusts are producing for the wholly owned subsidiaries are published and public, so that they can be scrutinised? In the case of the Airedale trust in my constituency, we discovered that 60% of the savings on purchasing are in VAT. Those figures should be in the public domain, so people can see what is being done with public money in their interests.

[Stephen Barclay]

The slightly puzzling issue here is that the savings accrued from the subsidiaries are for the benefit of the local health economy, of the trust. This is a subsidiary company 100% owned by its host trust. The more efficient the subsidiary is, the better it is at dealing with things such as its pathology—not only do we avoid samples being lost, but we run a more efficient system in a more commercial manner, which brings more money into the healthcare economy and gives the flexibility to compete effectively in the local job market for maintenance staff and others.

The benefits of those arrangements accrue to the trust that owns 100% of the subsidiary. That is why, under legislation of the previous Labour Government—correctly in my view, but clearly not in the view of the Labour Members—the local trust is empowered to empower in turn the local members of staff. That is then reflected in the staff survey, which shows a more favourable result in this trust.