Health and Care Bill

John Redwood Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Mr John Baron (Basildon and Billericay) (Con)]

rose—

[John Redwood (Wokingham) (Con)]

rose—

[Edward Argar]

I will make a little progress and then give way to my hon. Friend the Member for Basildon and Billericay (Mr Baron).

Currently, one in seven adults over 65 faces care costs of more than £100,000 over their lifetime. We are capping the amount that anyone will be forced to spend on personal care costs in their lifetime at £86,000. That is a seismic and historic change in the way we pay for care in England.

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[Edward Argar]

We have considered what help people want and when they want it.

[John Redwood]

rose—

[Edward Argar]

My right hon. Friend rose earlier and I should have taken his intervention then; I hope he will forgive me.

[John Redwood]

I am grateful to the Minister. Will he confirm that the amount of tax that is going to be raised in the immediate future, in national insurance and then in a separate tax, will make up a relatively small minority of the total costs of public social care? Will he also confirm that none of these measures addresses the issue of the hotel costs that people need to pay when they go into care homes?

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[Edward Argar]

Local authorities will have a seat on ICBs and on ICPs. The approach set out in the legislation is appropriate. We have sought throughout for it to be permissive, not prescriptive, and that remains the right approach.

[John Redwood]

Will the Minister give way on ICBs?

[Edward Argar]

May I make a little bit of progress? Depending on time, I may then give way to my right hon. Friend. I am conscious that hon. and right hon. Members want to speak—I suspect, primarily on new clause 49.

I turn to Government amendment 25. In doing so, I thank the hon. Member for Ellesmere Port and Neston (Justin Madders), whose birthday it is today—I wish him a happy birthday; I am sure that he can think of nothing that he would prefer to be doing—and the hon. Member for Nottingham North (Alex Norris) for their discussions about this issue. I do not know what view they have reached, but I am grateful for the helpful spirit in which they approached those conversations.

Although service provision—I emphasise the word “provision”—by the independent and voluntary sectors has been an important and valuable feature of the system under successive Governments, it was never the intention for independent providers to sit on integrated care boards and it still is not. We were clear that the conflict of interests provisions addressed the issue, despite misleading and inaccurate claims by some campaigners. However, we are happy to put the matter even further beyond doubt.

Government amendment 25 makes it clear that no one may be appointed to an ICB who would undermine the independence of the NHS, either as a result of their interests in the private healthcare sector or otherwise. We expect this to prevent, for example, directors of private healthcare companies, significant stakeholders of private healthcare companies and lobbyists from sitting on the board of an ICB. It would also prevent anyone with an obvious ideological interest that clearly runs counter to the NHS’s independence from sitting on a board of an ICB.

[John Redwood]

Will the Minister give us a brief comment on the recruitment of chief executives and senior management to the boards? Will we be using people who already have senior NHS jobs, meaning that there will be no redundancy and transfer costs, or will there be quite a redundancy bill because we want to change personnel?

[Edward Argar]

I think my right hon. Friend is talking about executive posts. Yes, there will be processes in place to ensure that employment rights are respected. There will be some roles that are completely new and there will be a competition, but I would expect that those with a significant track record and experience would therefore find themselves in a strong position. I will not prejudge any of those individual decisions.

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[Jeremy Hunt]

I see the Minister wants me to give way. May I make my argument for one moment, and then give way?

There is a plethora of internal NHS targets, there are operational targets and there are financial targets. They often have an excellent purpose, but, as in the case of Mid Staffs and other cases where things went badly wrong, being under a lot of pressure to meet those targets means corners can be cut, and the quality of care experienced by patients can be really damaged. The amendment would make sure that there was discipline in the system, so that whatever pressure NHS managers were under, they were always focused on safety and quality of care.

[John Redwood]

I pay tribute to my right hon. Friend for what he did as Secretary of State to stress the importance of this crucial work, and he is not on his own: I support him.