New Hospital Programme and Imperial College Healthcare NHS Trust

Debate between Matt Rodda and Will Quince

Tuesday 13th June 2023 Westminster Hall

[The Minister for Health and Secondary Care (Will Quince)]

It is a pleasure to serve under your chairmanship, Sir Mark. How do I follow that speech by the hon. Member for Bristol South (Karin Smyth)? Well, first, I would like to congratulate the hon. Member for Hammersmith (Andy Slaughter) for bringing forward the debate. I also thank my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) and the hon. Members for Westminster North (Ms Buck), for Strangford (Jim Shannon), for Reading East (Matt Rodda) and for Brentford and Isleworth (Ruth Cadbury). Time is short, but I will try to answer as many points as possible.

The new hospital programme is the biggest hospital building programme in a generation, which will help us deliver on our manifesto commitment to build 40 new hospitals by 2030. The hon. Member for Hammersmith raised a number of specific questions. I am not responsible for the new hospital programme, because that matter sits with Lord Markham. Nevertheless, I will endeavour to answer as many of the hon. Gentleman’s questions as possible. Furthermore, I know that Lord Markham would be pleased to meet him and colleagues, and I will ensure the hon. Gentleman gets a response to his letter.

On 25 May, we announced that the Government remain committed to building 40 new hospitals by 2030, and the new hospital programme is expected to be backed by more than £20 billion in funding for hospital infrastructure. It is the biggest hospital building programme in a generation. Going forward, new schemes will be considered through a rolling programme of capital investment in hospital infrastructure.

[Matt Rodda]

Will the Minister give way?

[Will Quince]

Time is very short, and I ask that the hon. Gentleman to let me answer as many of the questions as I can. If there is time, I will give way.

The programme is part of a more sustainable and consistent approach to delivering state-of-the-art new hospitals and will mean further investment to upgrade NHS facilities across the country. Our announcement is hugely significant to all hospitals in the programme and it gives funding certainty for trusts to progress their schemes in line with revised indicative allocations, most of which are a significant uplift on previous allocations.

I now turn to the specific questions. The hon. Member for Hammersmith said that the debate is about the defunding of the trust. I want to be clear that the trust has been informed of a significantly larger indicative allocation for both schemes than was previously given in 2019. Far from being defunded, the funding envelope has increased significantly.

Furthermore, no schemes have been removed from the programme, as the hon. Gentleman suggested. It is one programme, with a small number of schemes that will now complete beyond 2030. If I might correct the hon. Gentleman, he said that the pot is £20 billion; to be clear, it is over £20 billion.

On Charing Cross, I believe that the hon. Gentleman said that the temporary ward or decant facility will not be necessary until the main construction starts on the tower. That is part of the enabling works that have been raised, which can and should be completed well in advance of the main construction, and therefore can be used as extra capacity should there be a gap between the works. It is the first phase of that floor-by-floor work.

I understand that the main construction itself has not been postponed to start after 2030. We have been clear that, as part of the rolling programme, we may move schemes forward and backward—that question was raised by the hon. Member for Westminster North—based on their readiness to progress. The reason the two Imperial schemes were already in cohort 4 and are now in the rolling programme is that their plans are at such an early stage of development. If they are ready to progress sooner—or indeed other schemes, as the hon. Lady suggested, encounter problems along the way—some schemes may move forward and others may move back. Having the enabling works and business case ready is vital, and I know that hon. Members will have those conversations with the trust.

I will answer some of the other questions in a moment, but specifically on funding, I can confirm that Imperial and all other trusts will now have received confirmation of the individual indicative funding envelopes that give them the basis on which they can submit their proposals through the business case stages. Those individual scheme figures will not be released into the public domain, because they are commercially sensitive. I know that the hon. Member for Hammersmith would like to know the figures, but I hope he will understand why we will not release them: it could prejudice the future ability of contractors for tenders.

We announced that the programme is expected to be backed by over £20 billion, which gives trusts the funding certainty to deliver. We remain committed to delivering all the hospitals in the programme as soon as possible. Specifically on Imperial College, we are working closely with the trust on its two new hospital schemes within the programme. As the hon. Gentleman rightly said, that includes the rebuild of Hammersmith Hospital, the refurbishment of Charing Cross and the redevelopment of St Mary’s in Paddington, as well as any opportunities to commence supportive work ahead of the main construction starting.

Briefly taking each hospital in turn, Charing Cross is a large district general hospital with specialised services. It is a primary undergraduate training centre, and work is under way to explore practical options for a mix of new builds and refurbishment that will be phased across the site. We recognise that the 14-floor tower will need to be refurbished rather than rebuilt, as I mentioned. Other preparatory work that will be necessary, which the hon. Gentleman asked about, includes site-wide surveys and a new energy centre. As with all schemes in the programme, the funding is available for early enabling works such as those as soon as the trusts have their plans ready.

Hammersmith Hospital is a specialist hospital, as the hon. Gentleman said, whose specialisms include renal, haematology, cancer and cardiology care and, of course, its specialist heart attack centre and its research function. Plans for that scheme are also at an early stage of development and will require a phased approach due to space constraints.

Finally, St Mary’s is a large general district hospital, as my hon. Friend the Member for Cities of London and Westminster rightly pointed out, providing highly specialised services. The hospital will require a complete rebuild, and there are a range of options for a new site. We have been clear that we are establishing a new, centrally led programme to deliver those hospitals, which includes a new approach that enables standardisation.

The hon. Member for Hammersmith asked about the completion date for each hospital. The timelines are at an early stage. As a result, they are fluid, but I know that Lord Markham, the Minister in the Lords, will keep him updated on progress as work is undertaken with the trust to develop its proposals.

With a minute to go, I thank the hon. Gentleman for rightly raising this important issue and for his interest and engagement in the new hospital programme. I absolutely assure him that we are committed to the delivery of the two schemes at Imperial College Healthcare NHS Trust, and I thank all Members who have taken part in the debate.

Childcare Bill

Debate between Matt Rodda and Will Quince

2nd reading
Friday 29th October 2021 Commons Chamber

[Matt Rodda (Reading East) (Lab)]

I beg to move, That the Bill be now read a Second time.

Before I start, may I thank the Clerks and the Whips who have helped me to get to this point today? In particular, I thank the Lord Commissioner of Her Majesty’s Treasury, the hon. Member for Castle Point (Rebecca Harris), for her kindness and indulgence over a number of weeks.

I begin by recognising the contribution and hard work of the army of childcare providers in this country. Each day, thousands of families entrust their children to professionals who have dedicated their lives to caring for this nation’s young people. It is a vocation and it can be challenging, but without it we would all be so much worse off as a country.

The impact of the coronavirus pandemic and the necessary measures taken to keep us all safe have had a huge impact on children, and we now have an opportunity to work even harder to make up for the time that has been lost. We will all have seen in our constituencies the childcare providers who went all out to support the children of key workers. They put themselves in the frontline to keep our country going, while ensuring that children could continue their early years learning, even in the most stressful and difficult of situations.

I want every family in Reading, Caversham, Woodley and the whole United Kingdom to have the best possible start in life when it comes to their own childcare arrangements. I know that all Members of the House share that wish. We all want every young person to have the best possible start, and we all want to bring an end to the inequality that results from where someone is born, which can, even before their first birthday, shape their opportunities in life.

As the Chancellor of the Exchequer said in the Budget on Wednesday,

“the first 1,001 days of a child’s life are the most important.”—[Official Report, 27 October 2021; Vol. 702, c. 277.]

I genuinely welcome the announcement of investment in early years provision that the Chancellor made this week. It is clear that he and I, and I believe the whole House, share a view that we must level up childcare and early years provision in this country to support our children, support their families and, ultimately, support our economy. All the evidence shows that children who access early years education go on to achieve so much more.

This short Bill is entirely complementary to those Budget commitments and the House’s shared aspiration for our country’s children, and I will explain why. I will focus on three areas: first, the importance of a good start in the early years; secondly, the current system and where there is room for improvement; and thirdly, why it should be a national conversation and why we should have a serious debate about the future childcare system we want.

Every £1 invested in the early years is the equivalent of £8 invested in later education. Imagine any other industry or sector in which a £1 investment produced an £8 return every time—we would all be rushing, cheque books in hand, to invest. That is exactly what early years provision and childcare do for our children. Along with the love and support of parents and extended families, they provide a balanced and well-rounded introduction to life, which in turn reduces the cost to the country later. Every £1 invested gives children the skills and confidence that they need to learn, grow and thrive. It is what I wanted for my children, and what I want now for the nation’s children.

A well-resourced and comprehensive childcare offer in the early years is an engine that can drive social mobility. Early intervention, through early years provision, gives children a greater chance of accessing higher education and of securing apprenticeships. Those interventions really open doors later in life.

Every Member will have visited primary schools in their constituencies and heard from teachers of reception and year 1 classes who tell us that there is a marked difference in the development of children who have been immersed in early years support compared with those who have not. More people are accessing childcare now than a generation ago. The Nuffield Foundation reported that almost all children attend some form of early years education or childcare arrangement before entering school. That is a huge step forward for the country.

My Bill seeks not to amend or change the current provision in any way, but to champion it and to do all we can to ensure that everyone who is entitled to support knows about it and gets what they need. Clause 3 places a new duty on the Secretary of State for Education to prepare a strategy that promotes the availability of childcare and the benefits of early years provision to all eligible parents. As that is a devolved matter in the other nations of the United Kingdom, the Bill relates only to England. It would make the Secretary of State the named champion of childcare in England and it would compel the Department for Education to consider how the whole Government and the wider public sector, together with voluntary and private partners, can support and promote this important sector.

Crucially, the strategy would also have to consider how that information was delivered to parents in disadvantaged groups, which is levelling up. That is important because the research from the sector and think-tanks—I mentioned the Nuffield Foundation, which has done some excellent work on it—suggests that the children who would benefit most from free early years childcare are, sadly, least likely to access it.

According to the Nuffield Foundation, a third of children eligible for the funded two-year-old places are missing out, which is a tragedy. I want those children to access the help and support their families are entitled to, so that they can reach their full potential when they start primary school.

[The Parliamentary Under-Secretary of State for Education (Will Quince)]

indicated assent.

[Matt Rodda]

I am grateful for the Minister’s support and I know that he believes passionately in this agenda. Clause 3 seeks to do that by using the power of the Government and of the wider public sector and other partners to promote childcare availability to children who need it most—a modest ask that could make a huge difference to our whole country.

I turn to clause 2—I am approaching the Bill from the bottom up, which may be appropriate in the world of levelling up—which addresses the elephant in the room: what sort of childcare system do we want in this country? Much like clause 3, the clause does not seek to change current provision. I want to be clear about that to all Members present, and I believe we can work consensually on this important matter. I stand here today not to present answers but merely to facilitate a debate, with the support of the Minister and of other colleagues.

Governments of all political parties have been involved in shaping the childcare sector available to families today. From the Sure Start revolution of the last Labour Government to the new family hubs recently announced by the current Government, every Government have left their fingerprints on the sector. I am afraid this has led to a patchwork of provision in which postcodes, rather than local need, may determine services and in which anomalies have unfortunately been allowed to flourish. This does little to close the educational attainment gap, about which I spoke earlier.

Some areas are blessed with maintained nurseries, and Reading is one of those lucky areas. It is a system in which teacher-led provision, maintained by local authorities, provides the early years foundation curriculum in a more formal setting. I pay tribute to the maintained nurseries in my constituency and in other parts of Reading for their excellent work. However, local authority funding is currently challenged and there has been a decline in the number of places available across the country. Some maintained nurseries, luckily not in my area, have closed their doors.

Other communities are fortunate to have well-run provision in the private and voluntary sectors, either independent or linked to a primary school or multi-academy trust. There is a good mix between early years, as a precursor to school, and other long-established community providers that have often cared for successive generations of each family.

Consistency varies across the country and funding arrangements, due to their complexity, can be off-putting. Some two-year-olds may be eligible for free childcare depending on household income or entitlement to certain benefits, such as universal credit or tax credits. People who earn less than £16,000 before tax and are in receipt of tax credits will be eligible for a free place for their two-year-old. If their child is entitled to disability living allowance or personal independence payment, they may also be eligible for a free childcare place at the age of two.

However, everything changes when the child turns three, when all children become eligible for 15 hours of free childcare regardless of whether their parents are working. Working parents may be entitled to an additional 15 hours a week, taking it up to 30 free hours, but these extra hours are available to some other parents depending on household income and circumstances. My description shows how the system is complicated and difficult for parents to understand.

Although the system for three-year-olds does not sound too dissimilar to the arrangements for two-year-olds, I am afraid it is. The eligibility for two-year-olds is aimed at the lowest paid and the unemployed, but the eligibility for the additional 15 hours for three and four-year-olds is for those who work more than 16 hours a week and who have a household income up to £100,000. This means that the additional hours are disproportionately going to the children of wealthier parents who are in work and whose educational development is less likely to be held back. Unfortunately, this extra money is going to those slightly better off families.

My Bill does not propose changing the thresholds, but clause 2 would require the Secretary of State to appoint an independent person to lead a review of childcare schemes across England.