Covid-19 Update

Peter Bone Excerpts

Tuesday 5th May 2020 Commons Chamber

[Matt Hancock]

The public can have confidence, not least because the data will be held on people’s own phone until they need to contact the NHS when, naturally, they will of course need to tell the NHS their identity in order to be tested. In that sense, privacy is there by design.

The wider point is that the app and the test, track and trace system will help to keep people safe. As I said yesterday when I launched the pilot in the Isle of Wight, people should download the app to protect the NHS and save lives. It is the civic duty of people on the Isle of Wight to do so, and it will be the civic duty of people throughout the country to do so. It has been designed with privacy at its heart. We are putting the source code on the internet so that people can see exactly what the app does. That reassurance, along with the motivation that they are helping to protect themselves and their community, will, I hope, lead to an awful lot of people downloading the app. I certainly will.

[Mr Peter Bone (Wellingborough) (Con) [V]]

Mr Speaker, further to your opening remarks at the beginning of this urgent question about new policy being announced by Government in the House and not to the media first, the Secretary of State side-stepped the question when it was put to him by my hon. Friend the Member for Christchurch (Sir Christopher Chope), so I will try again. Does my right hon. Friend agree with Mr Speaker that statements of new Government policy should be made in this House first, and will he advise the Government to put off making the statement on Sunday until Monday and make a statement in the House?

[Matt Hancock]

The exact scheduling of any announcement is, of course, a matter that has to be considered across Government, but I will take away my hon. Friend’s concerns and ensure that they are looked into.

Health and Social Care (Kettering)

Peter Bone Excerpts

Wednesday 23rd October 2019 Westminster Hall

[Mr Hollobone]

I am delighted to take that intervention from my hon. Friend, who is a superb representative for his constituents in Northampton and is very much in touch with the importance of local healthcare issues to our constituents. He is absolutely right.

I am delighted to welcome the Government’s commitment to include Kettering General Hospital on the list of hospitals that will be considered for health infrastructure plan 2—or HIP2—funding from 2025. That is important for Kettering, because the hospital has been there for 122 years, 70% of the buildings on the main hospital site are more than 30 years old and there is a maintenance backlog of £42 million. We need the reconstruction of many wards at the hospital. I welcome the Government’s commitment to investment in the hospital site from 2025 onwards, which could transform the whole of Kettering General Hospital. The point about the urgent care hub is that we need the money now to address the pressure on the A&E department.

The second part of the debate is about the need for us to use the opportunity of local government reorganisation in Northamptonshire to create in the county a combined health and social care pilot that will put responsibility for healthcare and social care under one organisation. Northamptonshire County Council has faced tremendous financial difficulties. The Government appointed an inspector, who concluded that it was not possible to turn around the organisation. The Government’s solution is to create two unitary councils in the county: a “north” council and a “west” council that will take over all the responsibilities of the eight different councils in the county from May 2021. We can use that once-in-a-generation opportunity to create a new organisation on a pilot basis to combine health and social care in Northamptonshire.

That is important for Kettering General Hospital because it has 531 beds; at any one time 110 of those beds—21%—are occupied by patients who should not be in hospital at all, but in a social care or other setting. In Government jargon, they are defined as super-stranded patients who have been in hospital for more than 21 days. If the hospital discharges 87 patients a day from the A&E department to the hospital, and 110 of the beds are occupied by patients who should be in a different setting, it creates huge problems for the A&E department, so finding a solution to the social care issue is also important for the A&E department.

[Mr Peter Bone (Wellingborough) (Con)]

I congratulate my hon. Friend on having led a seven-and-a-half-year campaign to get the expansion at Kettering General Hospital. It has been my great pleasure and that of my hon. Friend the Member for Corby (Tom Pursglove) to support him, but he has led this magnificent campaign and I hope that today he will succeed in his objective. Does he agree with me that the reorganisation he has talked about could possibly—hopefully—lead to an urgent care centre at the Isebrook Hospital in my constituency, which would reduce the number of people who go to Kettering A&E by 40%?

[Mr Hollobone]

I would be delighted to support my hon. Friend’s campaign. He is a very effective champion for his constituents. He, along with my hon. Friend the Member for Corby, has been an integral part of a joint effort to campaign for the urgent care hub at Kettering. I would be delighted to reciprocate, because health investment in our local constituencies is very important for our local residents.

My hon. Friend the Member for Wellingborough will join me in welcoming any proposals that the Government introduce to create a health and social care pilot in the county. We simply have to make sure that elderly, frail residents in hospital, who need not be there and should be in a social care setting, are given the social care that they need in the right place at the right time. With social care now the responsibility of Northamptonshire County Council, I am afraid it simply is not working.

Evidence shows that the longer an elderly person stays in hospital, the more they lose critical muscle mass and strength, which affects their ability to return to their home or social care setting without appropriate support. Patients with long lengths of stay in hospital become revolving door patients. They get better and could go to a community setting of care, but they become unwell again because they wait so long for an appropriate out-of-hospital placement, so we need to get that sorted out. Financially, it does not make sense, either. If a patient stays in hospital, it costs £2,500 a week. If they are put into a social care setting, the cost to the taxpayer is £700 a week. Not only is the setting more appropriate, but it is financially beneficial for our health and social care providers.

I am pleased that the Secretary of State for Health and Social Care, together with the appropriate Minister in the Ministry of Housing, Communities and Local Government, wrote to all Northamptonshire MPs on 24 July, encouraging Northamptonshire County Council and the local NHS providers to knock their heads together to thrash out an appropriate plan. The Secretary of State wrote:

“I agree that the unitarisation process offers an excellent opportunity to re-imagine the delivery of health and social care services across Northamptonshire. I believe that local leaders should be bold in their ambitions for integration”.

He stated that he and the Housing, Communities and Local Government Minister

“are happy to back a bolder plan for integrated services in Northamptonshire, learning from other areas that are further ahead in the integration journey”,

such as Greater Manchester. Since that letter of 24 July, my colleagues and I, as parliamentary representatives from Northamptonshire, have seen little evidence of any concrete proposals from the county council and the local NHS. It is time for the Government to knock heads together locally, because the Government will want a pilot to pioneer their reform of health and social care. We have a wonderful opportunity in Northamptonshire to be the first in a shire setting to get it right.

Local organisations are doing their best in the present circumstances—I declare my interest as a member of Kettering Borough Council. To give one example, Karen Clarke, a housing options adviser at Kettering Borough Council, has been working extremely hard to make sure that patients can come out of hospital and find appropriate accommodation if they have difficulties in doing so. She recently wrote:

“I think the majority of the public assume everyone goes in to hospital, receives their treatment and is discharged home, but what if that patient doesn’t have a home? Or what if their home is no longer accessible? What if someone needs more than just independent living? Where does the patient go then?”

Karen has seen more than 250 patients in the past two years. She has managed to return home, or to secure permanent accommodation for, approximately 7% of those referrals, and 25% have gone into some level of temporary accommodation. That pioneering initiative is at Kettering’s health and housing partnership, where Kettering Borough Council, the local mental health trust and Kettering General Hospital work together. It has been pioneered by John Conway, the inspirational head of housing at Kettering Borough Council. It is a superb initiative.

However, such local initiatives are not enough. We need one organisation, preferably NHS-led, to sort out health and social care provision in Northamptonshire. The Government have a golden opportunity to pioneer a pilot in the county, so I hope they will press ahead. There are two issues: we need £46 million for an urgent care hub at Kettering General Hospital, and we need the Government to seize the initiative, knock heads together locally, and make sure we can have a pilot for health and social care in Northamptonshire.

Health Visitors (England)

Peter Bone Excerpts

Wednesday 23rd October 2019 Westminster Hall

[Several hon. Members rose—]

[Mr Peter Bone (in the Chair)]

Order. It might be helpful to right hon. and hon. Members to let them know that the wind-ups must start at 5.15 pm, and that there are four Members trying to catch my eye. I hope Members can bear that in mind.

--- Later in debate ---

[Julie Cooper (Burnley) (Lab)]

It is a pleasure to serve with you in the Chair, Mr Bone. I thank the hon. Member for East Worthing and Shoreham (Tim Loughton) for bringing this important subject before us, and for the sterling work that he does chairing the all-party parliamentary group for conception to age two—the first 1,001 days.

We have had some really interesting speeches, and I thank all Members who have spoken for some very convincing contributions that have outlined very clearly the massive contribution that health visitors make to communities and to individual families, covering all sorts of services—from basics such as the transition to parenthood, particularly helping new parents, to support with breastfeeding and weaning, and encouraging the full take-up of immunisations. It has been pointed out that we have a very poor record on that. Health visitors also support the mental health of parents who might be feeling vulnerable in their new role; advise on a host of minor ailments from which children might suffer; ensure readiness for school; check that developmental changes are happening at the appropriate stage; and help to pick up early any special needs and problems.

The hon. Member for East Worthing and Shoreham talked about the importance of safeguarding and the cost—not just the cost to the family, but the financial cost of services when it does not happen. Health visitors, as registered nurses with additional midwifery, community and public expertise, play a tremendous role. I do not think that there is any disagreement in the Chamber about the contribution that they make. Praise for them among health professionals is widespread. The president of the Royal College of Paediatrics and Child Health has said:

“Health visitors act as a frontline defence against multiple child health problems”.

The Children’s Commissioner for England said:

“Health visitors are an essential part of the country's support structure for young children and their parents”.

My daughter Anna became a new parent six months ago today. Ahead of the debate, I asked her what she thought of her health visitor. She said:

“We loved our HV. We didn’t have consistent midwifery care—a different midwife every week before and after Nora was born—but we had one HV who first visited me before Nora was born and told me she would be my health visitor throughout the early stages of me becoming a mum. We found her especially helpful when Nora started struggling”

with feeding. Anna also said of her health visitor that

“we’d been discharged by the midwife and didn’t want to bother the GP. She was just a phone call away or would pop to see us.”

I am grateful to the hon. Member for Liverpool, Wavertree (Luciana Berger) for what she said about the benefit she had from health visitors. There is no disagreement about their value, and I put on the record my thanks to health visitors across the country for the sterling work that they do in times of considerable difficulty and challenge. They are very much a British phenomenon. We are the envy of the world, having health visitors—and with good reason. We all know that there is nothing more important than giving children the best possible start in life.

Bearing all that in mind, it is distressing to hear that the number of health visitors is falling so drastically. We are going backwards and it is extremely worrying. The Minister may point to the fact that David Cameron increased the number of health visitors, but that is old news, and the picture now is very different. In 2015, there were 10,300 health visitors; by 2017, that number had fallen to 8,244. The reality is that every month the numbers fall. None of that is really surprising considering that, in late 2015, public health and the commissioning of health visitors became the responsibility of local authorities. That transfer of responsibility was accompanied by a budget reduction of 6.2% and the requirement to cut year on year until 2020. Funding for health visitors is not ring-fenced, so is it any wonder that cash strapped authorities are commissioning fewer and fewer?

I raised my concerns about this last year with the former Health Minister, the hon. Member for Thurrock (Jackie Doyle-Price). She said:

“health visitors are probably the most important army in the war against health inequalities. They provide an intervention that is very family-based and not intimidating…There has been a decline…which we really must address if we are to get the earliest possible intervention and the best health outcomes for children.”—[Official Report, 23 July 2019; Vol. 663, c. 1204.]

I totally agree. That was said last year, and the Government have failed to act and the numbers have continued to fall.

The numbers of children have not fallen, though, and it is therefore important to recognise the increased workload of the remaining health visitors. My hon. Friends the Members for Heywood and Middleton (Liz McInnes), for York Central (Rachael Maskell) and for Lincoln (Karen Lee) all raised the falling numbers, and pointed to the fact that the Institute of Health Visiting current caseload identification exceeds safe levels. The recommended maximum caseload for health visitors is 250. The Care Quality Commission reports that the average is 500 and, in the London Borough of Hounslow, the average number—not the highest—is 829 per health visitor. That is obviously affecting their ability to deliver a quality service, and it is now true that the proportion of six-to-eight-week reviews completed for newborn children ranges from 90% in some areas to only 10% in others. It seems that vital workforce planning is a thing of the past, and our children and communities are paying the price.

In the widest sense, that approach is so short-sighted. No health professional is better placed than a health visitor to support parents and children in those vital early years. The early intervention of a well-qualified, accessible health professional can be the difference between children thriving and not. For every child who does not thrive, there is a cost, not just to the family but to wider society. There is a wealth of evidence to demonstrate the high impact that health visitors have in key areas.

[Mr Peter Bone (in the Chair)]

Order. I am sorry to interrupt the shadow Minister, but there is a guideline of five minutes for shadow Ministers in these debates, with 10 minutes for the Minister. We are cutting into her time, so I hope the shadow Minister has finished her speech.

[Julie Cooper]

May I make a couple of final points?

[Mr Peter Bone (in the Chair)]

Of course—very quickly.

[Julie Cooper]

Today, the Minister has heard an appreciation of the contribution of health visitors. We look to her to address the question of future provision, and outline how she is going to turn around the decline in numbers.

--- Later in debate ---

[Jo Churchill]

I thank my hon. Friend for his intervention, which links to the fact that fragmentation also remains a challenge throughout the system, running counter to the aim of whole family support that my hon. Friend the Member for East Worthing and Shoreham mentioned. I believe strongly that there is scope to improve collaboration between councils and NHS bodies in order to improve delivery, particularly on important issues such as breastfeeding, immunisation and the like. The digital child health programme is one area in which we are helping to overcome barriers, securing national backing so that information is shared properly between key professionals. That is particularly important for strengthening the links between primary care and health visitors. However, there are further areas in which we can work together better to support those with higher needs, and I intend to reflect on the points made during this afternoon’s debate and work further on the recommendations of the “Vision for the Future” report.

The commitment to grow the public health grant as part of the local government settlement underlines the Government’s commitment to protecting and improving the health of the population. Local leaders remain well placed to make decisions for their communities; there is a disparity across the piece, and we need to better understand the data. Local decisions should be based on robust assessments of local needs, supported by workforce plans.

Research also suggests that there are short and long-term educational and socio-emotional benefits from early childhood education and care. That is why we have prioritised investment in early education; the 15 hours of free early education for disadvantaged two-year-olds is welcome. However, those benefits start earlier—with a person’s interaction with their health visitor when they are 28 weeks pregnant, or even before that, in personal, social and health education lessons in schools. In those lessons, we talk about healthy relationships and equip our young people with advice on issues such as substance abuse and parenting.

In the prevention Green Paper, we announced our commitment to modernise the Healthy Child Programme to reflect the latest evidence about how health visitors are part of a wider integrated workforce, providing support. Doing so provides an important opportunity to work with partners, and I will take my hon. Friend the Member for East Worthing and Shoreham up on his offer, made in his recent letter, to bring with him academics and other interested parties—I note that there are interested parties across this Chamber—to talk about how we can best move this forward. I want to ensure that support is both universal in reach and capable of a personalised response, focusing support where the additional needs suggest we should put it.

I understand the continued focus on five mandated contacts, which provide a vital opportunity for contact with families, and national data shows that coverage has improved. However, I take on board the points that have been made; I do not want to reduce contact to those five moments, and there have been some interesting conversations about other points of contact. I have heard some within the health visiting profession say that they are being pushed to tick the box but miss the point, and I have spoken to my local health visitor lead about that issue. Health visitors are highly qualified professionals who have an important leadership role, and I wish to reinvigorate that role. Through working closely with commissioners and other professionals, particularly midwives, health visitors are critical to a child’s journey.

If we are serious about supporting early intervention, that means starting with relationships. Becoming a parent is an important time in anyone’s life, but it does not come with a manual; we all need help, and professionals have an opportunity to give evidence-based advice and support. Our vision for prevention encompasses the whole of life. We are now reviewing the prevention Green Paper, including the response to it by my hon. Friend the Member for East Worthing and Shoreham. We will ask ourselves what more can be done, and we will work with local authorities and NHS bodies to address that question.

To give every child the best possible start in life and the opportunity to fulfil their potential, we need to fundamentally change the way we operate. I want to ensure that systems are in place to help infants as they develop, move to school and grow into adulthood; to overcome fragmented service provision; and to make the best of what exists, while using the evidence to maintain a resolute focus on additional needs. I look forward to working with my hon. Friend, and I am optimistic that we can make the change.

[Mr Peter Bone (in the Chair)]

I apologise to right hon. and hon. Members, but time has beaten us, so I am afraid that the sitting stands adjourned.

Leaving the EU: Health and Social Care

Peter Bone Excerpts

Tuesday 19th March 2019 Westminster Hall

[Brendan O'Hara]

I thank everyone who has taken part in the debate. The shadow Minister said that this is the most important issue of the day, and she is right, so where are her colleagues? Every constituency in the country will be badly affected by this issue.

[Mr Peter Bone (in the Chair)]

Order. I apologise to right hon. and hon. Members, but time has beaten us. I place on the record my particular thanks to the Minister for not reading a prepared speech and for dealing with the questions that Members asked.

Motion lapsed (Standing Order No. 10(6)).

Ovarian Cancer: Diagnosis and Treatment

Peter Bone Excerpts

Tuesday 30th October 2018 Westminster Hall

[Lee Rowley]

I thank all right hon. and hon. Members who have contributed to this exemplary debate. It has been one of those debates that we all aspire to have, in which we talk about the detail and leave out a lot of the politics, and in which there is unity regarding wanting the same outcome: we all want to be able to treat the disease more quickly, with better outcomes and fewer people experiencing it. I am grateful to everyone for entering into the discussion in that spirit.

I thank the hon. Member for Strangford (Jim Shannon) for attending this morning, for highlighting the importance of the issue to him, and for mentioning all the work being done in Northern Ireland—particularly for raising the point about genome testing. I thank my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for sharing his experience north of the border. He, like so many others, provided some of the most important elements of the debate—examples of constituents’ own experiences. I also thank the Front-Bench spokespeople: the hon. Member for Lanark and Hamilton East (Angela Crawley) for also sharing her experience north of the border; and my colleague on the all-party parliamentary group, the hon. Member for Washington and Sunderland West (Mrs Hodgson), who spent so much time highlighting the group’s great work. It has been a privilege to be part of that work over the past few months; the report is a great piece of work and I hope to see improvements coming out of it.

I also thank the Minister. I am a relatively new Member, but I can often tell in debates when Ministers are going through the motions and when they actually care, and today I have heard a speech that demonstrates a genuine interest. It was great to hear about the Minister’s personal connection and about how he cares about the issue, and it was interesting to hear some of the things he highlighted. “Lots to come” is the summary I think it is fair to say we can take from the speech, with regard to the ACE centres, the potential for more public health campaigns, the genome point and the screening. I was particularly glad to hear about the dashboard, which I hope, in time, will give us an opportunity to push forward and demonstrate greater transparency.

Although they are not all still in their place, I thank my hon. Friends the Members for Grantham and Stamford (Nick Boles) and for Nuneaton (Mr Jones), my right hon. Friend the Member for Chipping Barnet (Theresa Villiers), and the hon. Members for Blaydon (Liz Twist), for Torfaen (Nick Thomas-Symonds) and for Upper Bann (David Simpson). I am incredibly grateful for their contributions. I also thank everyone in the Public Gallery, who has listened and provided support. I am aware that there are Members in the room to whom the matter means much but who, by convention, are not able to speak: my hon. Friend the Members for Erewash (Maggie Throup) and you, Mr Bone. You are undertaking a different role today, as Chair, but you were so kind in supporting me when we applied to the Backbench Business Committee for the debate. I am grateful to you and my hon. Friend for your silent but heartfelt support.

This is an important area. It has affected me personally, but it is not about the personal effects; it is about ensuring that we make progress as a country in sorting out the disease and resolving the issues, reducing the number of people out there who get a diagnosis. The debate has shown that a lot has been achieved, that a lot can be done, and that there is a lot of progress we can make, and I look forward to seeing that progress in the coming years.

[Mr Peter Bone (in the Chair)]

I thank all Members for the excellent debate.

Question put and agreed to.

Resolved,

That this House has considered ovarian cancer diagnosis and treatment.

Health and Social Care (National Data Guardian) Bill

Peter Bone Excerpts

3rd reading: House of Commons & Report stage: House of Commons
Friday 6th July 2018 Commons Chamber

[Mr Peter Bone (Wellingborough) (Con)]

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

You will be pleased to learn, Mr Deputy Speaker, that with 266 days until we leave the European Union, I will not mention red lines or anything like that. But I congratulate my hon. Friend the Member for Lewes (Maria Caulfield) on navigating her Bill through this place. The Government have clearly been listening to her, because I understand that at Chequers today all the mobile phones have been confiscated.

It gives me great pleasure to promote this important Bill, and I am grateful for the cross-party support. I am keen to get through Third Reading as quickly as possible because there is another important Bill to follow, and hopefully there will be time for that debate.

The purpose of this Bill is to put on to a statutory footing the office of the National Data Guardian for Health and Social Care, and to promote the provision of advice and guidance on the processing of health and social care data in England. Many people have helped me in preparing the Bill, and I would like to thank some of them.

It would be wrong not to start with my hon. Friend the Member for Bury St Edmunds (Jo Churchill). She was one of the Bill’s original sponsors but, because she has been promoted into the Government, she can no longer speak on the Bill. It is due to her tenacity that the Bill is now being considered for the Third time. If she were able to say something, she might say something like this:

“The confidence that a statutory National Data Guardian brings, allows for more responsible and innovative uses of data to work towards cures for cancer and other conditions.

The Bill will empower the National Data Guardian to ensure that cancer researchers can take full advantage of the future possibilities of genomics and Artificial Intelligence, and whatever comes after genomics and AI, where every patient can have confidence that their data will be used in a way which is consensual, safe, and transparent.

For the vast majority of patients (98%) who are happy for their data to be used, it also helps them have confidence that not only can their data be used, but that it will be used, responsibly, for the purposes patients already expect.

It is important that this brief but important piece of legislation gives patients the confidence they need to engage with health data for not only their own care pathways but also giving them choice in sharing when they wish.”

I am grateful for all her efforts behind the scenes to get us to Third Reading.

I also thank the Secretary of State for Health and Social Care, who kindly wrote to me yesterday:

“Placing the National Data Guardian on a statutory footing is significant in increasing public trust in the appropriate and effective use of health and care data, in promoting challenge and building assurance across the health and care system, and enabling the system to access the data that it needs to run safely, effectively and efficiently.

I would like to once more confirm the Government’s commitment to the Bill.”

I am grateful to him for that letter.

The excellent Minister at the Dispatch Box, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), has been so helpful in the preparation of this Bill. She has put more work into this than she had to, and I really appreciate her help.

The National Data Guardian’s role is to help to make people safe and to give them confidence that their information is securely safeguarded. Dame Fiona Caldicott is the National Data Guardian. I do not know whether hon. Members have met her, but she is a formidable lady. There are Caldicott guardians in every hospital, and we are now putting her role on a statutory footing. Her help in preparing the Bill has been immense. I hope she will go on for many years but, when she does retire, there will be a new National Data Guardian—that will definitely happen.

The priority of the National Data Guardian is to build trust in the use of data across health and social care. The Data Guardian is guided by three main principles:

“encouraging clinicians and other members of care teams to share information to enable joined-up care, better diagnosis and treatment;

ensuring there are no surprises to the citizen about how their health and care data is being used and that they are given a choice about this; and

building a dialogue with the public about how we all wish information to be used, to include a range of voices including commercial companies providing drugs and services to the NHS, researchers discovering new connections that transform treatments, and those managing the services”.

I am also very grateful to Baroness Caroline Chisholm of Owlpen, who will be taking the Bill through the House of Lords, should it receive its Third Reading today. She will be known to many on the Conservative Benches, as we had to deal with her when she was head of candidates, so many of us here will appreciate her greatly. I also want to give particular thanks to the Labour Opposition and to the shadow Minister for all his support. I am in a difficult position, in that my Bill got its Second Reading after the Bill that would change the parliamentary constituencies. Every week at Prime Minister’s questions, the public think it is about party political point scoring and that we never work together. Of course that is not what happens; the vast majority of Bills that go through this House are improved by what the Opposition do, as is the case with my Bill. I particularly want to thank the Opposition for not blocking this Bill. I have to say that when the Speaker was in the Chair and this Bill, standing in my name, came up for its Second Reading, he paused for a very long time, expecting someone to object—presumably he thought it would be someone from our side. It would have been quite appropriate if the Labour Opposition had objected to my Bill if they had wanted to do so because it went ahead of their Bill, which had already got its Second Reading. I am therefore very grateful to the Opposition. I have chosen today for the Third Reading so that there are still opportunities for that Bill to proceed, if it is given its money resolution.

I do not want to take too much more time, because I understand the pressure we are under today, but I wish to mention a couple of things that were raised in Committee. I am grateful in particular to my hon. Friends the Members for Christchurch (Sir Christopher Chope) and for Shipley (Philip Davies), and the hon. Member for Rhondda (Chris Bryant) for their involvement in the Committee. I was brave to put those three on a Committee, but the hon. Member for Rhondda asked a particularly difficult question. The Minister answered it well, but, on reflection, I can now provide a bit more clarification. This Bill says that it extends to the territory of England and Wales, which it does, but it applies only to England. The logical question was, “Why on earth did it apply to England and Wales then?” In layman’s terms, the answer is simply that as a legal entity in Parliament England does not exist, and England and Wales are lumped together. We can have a Bill that extends to England and Wales; to England, Wales and Scotland; or to England, Wales, Scotland and Northern Ireland. That is the answer on this point, and this Bill applies only to England. On reflection, I recall that I am a fellow of the Institute of Chartered Accountants in England and Wales. I do not think I quite managed to get the answer across on that point in Committee.

[Chris Philp (Croydon South) (Con)]

Can my hon. Friend let the House know what the equivalent arrangements are, if any, in Wales and Scotland?

[Mr Bone]

The answer to that, of course, is that those places have devolution and it is up to them to make their decisions. Obviously, I believe that what we are doing in England is best practice and I am sure they will take note of it. At that point, I ought to conclude. I thank everyone for their help so far, and I hope we can make progress later on.

--- Later in debate ---

[Mr Bone]

With the leave of the House, I thank the parliamentary counsel, the Clerks of the House and officials at the Department of Health and Social Care for their assistance in preparing the Bill. I also thank, from my office, Jordan Ayres for the research and Helen Harrison for the drafting of the Bill. I also thank the eight Back-Bench MPs who have taken the opportunity to participate, particularly my hon. Friends the Members for Corby (Tom Pursglove) and for Torbay (Kevin Foster), both of whom sat on the Public Bill Committee.

The last thing to say on the Bill before, hopefully, it is read for the Third time is that, if it makes it all the way through and becomes an Act of Parliament, let us hope it is referred to as the Churchill Act.

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

There might already be one or two Acts with that name.

Question put and agreed to.

Bill accordingly read the Third time and passed.

Health and Social Care (National Data Guardian) Bill

Peter Bone Excerpts

Committee Debate: 1st sitting: House of Commons
Wednesday 6th June 2018 Public Bill Committees

[The Chair]

With this it will be convenient to consider that schedule 1 be the First schedule to the Bill.

[Mr Peter Bone (Wellingborough) (Con)]

It is a great pleasure to serve under your chairmanship, Dame Cheryl. I welcome the Minister and shadow Minister to the Committee.

The purpose of the Bill is to put on to a statutory footing the office of the National Data Guardian for Health and Social Care, and to promote the provision of advice and guidance about the processing of health and adult social care data in England. It would be remiss of me not to mention the work of my hon. Friend the Member for Bury St Edmunds (Jo Churchill): she has worked hard for a long time to establish the position of the National Data Guardian for Health and Social Care, and her perseverance and tenacity have ensured that we are on track to deliver it.

I thank the Minister and shadow Minister for their help and support with the Bill—and special thanks, of course, go to Dame Fiona Caldicott, who has pioneered the work on ensuring that the NHS handles data properly. She has been very helpful to me in the preparation of the Bill.

Clause 1 creates the Office of the National Data Guardian for Health and Social Care, referred to in the Bill as the “Data Guardian”. It makes general provisions about the Data Guardian’s functions and the way in which they are to be carried out. Subsection (2) empowers the Data Guardian to publish guidance about the processing of health and adult social care data in England. I should like to make it clear that it also covers public health data.

Subsection (3) imposes a duty on certain organisations and individuals to have regard to the National Data Guardian’s published guidance. Comment has been made as to why the Secretary of State is not included in the list. However, the Department of Health and Social Care is already included in the definition of those who have to have regard to the National Data Guardian’s advice, so it would be superfluous to include the Secretary of State.

Subsections (4), (5) and (6) cover requirements in relation to the Data Guardian’s published guidance. Those subsections are intended to keep the guidance relevant over time and, if necessary, updated to reflect new evidence. It has been suggested that subsection (5) should add an obligation that organisations and individuals that process health and social care data should provide the Data Guardian with appropriate information. I argue that that would create a duplication of the remit of regulators that already exist in those sectors. The Data Guardian’s role is as an advocate for the patient and the public, to build and maintain public trust. The role is as much about supporting individuals and organisations to get it right first time as it is about commenting, advising and providing guidance. It is not the intention of this Bill to create another regulator, but that the National Data Guardian should work with the Information Commissioner’s Office and the Care Quality Commission.

It has also been suggested that subsection (6) should add a duty that all data controllers and their data processors must publish their response to all advice issued. That would be extremely burdensome on those organisations and individuals, and it would be toothless without sanctions. Accountability should be assessed through actions, not written responses; the existing regulators would be able to assess the adherence to guidance and would cite the National Data Guardian during any investigation.

Clause 1(7) allows the Data Guardian to give informal advice, assistance and information to anyone, as long as it is about or relates to the processing of health and adult social care data in England. Clause 1(8) gives the Data Guardian flexibility in how far any particular piece of advice, assistance, information or guidance may be extended. The effect is to clarify that the Data Guardian can publish guidance and give advice on specific topics or themes, and can target it to certain organisations, individuals or sectors as appropriate. Clause 1(9) provides that the duty to have regard to the Data Guardian’s published guidance applies only in so far as the guidance is relevant to the functions or services of the body or person.

Clause 1(10) introduces schedule 1 to the Bill. As clause 1 and schedule 1 are being debated together, I will make some brief comments on schedule 1. The schedule makes further provision for the establishment, maintenance and operation of the Office of the Data Guardian. It sets out the Data Guardian’s terms of appointment and covers a broad range of matters related to the Office of the Data Guardian. It includes its constitution, its financial and reporting framework, and how members of staff and advisers are reported and remunerated. I draw the Committee’s attention to paragraph 15 of schedule 1, which provides that the Secretary of State must pay to the Data Guardian the amount that he considers appropriate for the purpose of enabling the Data Guardian to carry out his or her functions.

The Committee will be aware that there was some debate about the cost during the money resolution debate. I thank hon. Members who are here today and those who took part in the debate. I want to make clear that, although the estimated cost is £725,000 per year, that is only an additional £225,000 per year and relates to putting the Data Guardian on a statutory footing. As the Committee will know, there is already a Data Guardian, which costs £500,000; we are just putting this on a statutory footing and saying it is the right thing to do.

[Sir Christopher Chope (Christchurch) (Con)]

I congratulate my hon. Friend on having got his Bill so far. On the costs, the Data Guardian will basically be indemnified for the costs incurred, yet I see that the Data Guardian will have enormous flexibility to publish and give as much guidance or advice as they wish. Surely the Data Guardian could, by giving a lot more advice and guidance over which there is no control, result in significantly increased costs for the public sector?

[Mr Bone]

I am grateful for my hon. Friend’s intervention and the fact that he is on the Committee; I know that all Committees welcome his membership.

The reason why we have a Data Guardian is to provide safeguarding and to make sure that the data is handled properly. Those costs can only be estimated; as my hon. Friend says, they could be more or less, depending on the requirements. That is exactly why we need a guardian. I would like the costs to be minimal, because that means that we are handling the guardian properly. But if there needs to be more, because there is a requirement to do more, there will be more cost.

[Sir Christopher Chope]

Does my hon. Friend know of any case where a regulator given powers by Parliament has chosen to reduce the amount of powers that are used? Surely, the natural thing is for regulators to increase their activity, using the powers to the maximum and thereby increasing the costs.

[Mr Bone]

I agree, but what we are not doing today is creating a regulator; I would not be likely to propose a Bill to create a regulator. The Data Guardian already exists and it is not a regulator—I specifically said that in my opening remarks. Although it is probably true that regulators do that, that is not what I expect to happen with the National Data Guardian.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure, as always, to serve under your chairmanship, Dame Cheryl. I congratulate the hon. Member for Wellingborough on his notable success in getting the Bill to this stage, and I thank him for his candour during the debate on the money resolution and for his acknowledgment of his good fortune in getting the Bill to this stage ahead of others.

As I mentioned when we debated the money resolution of the Bill, Labour Members welcome the decision to put the National Data Guardian for Health and Social Care on a statutory footing. On that basis, we agree with the thrust of the Bill. I am sure that colleagues will be relieved that I do not intend to speak for too long, but I have one or two comments and observations about clause 1—and about clause 2, which we will discuss a little later. I hope that the Minister will be able to respond to the points made by the hon. Member for Wellingborough, some of which I was going to make anyway.

I mentioned when the money resolution was debated that although the use of data has the potential to improve our health services and treatments beyond recognition, we know from past experience that use of data in the NHS and in wider society can prove controversial and carries high levels of suspicion among patients. We hope that the establishment of the Data Guardian on a statutory footing can give patients confidence that their medical information will be treated in the correct manner. I note from the comments of the hon. Member for Wellingborough that there seems to be an omission from clause 1 as it stands, as there does not seem to be an opportunity for the National Data Guardian to give advice to the Secretary of State himself, although he considers that duty to be covered elsewhere and that such as an addition would be superfluous.

There seems to be a discrepancy that leaves the Data Guardian in an inferior position to either the existing Confidentiality Advisory Group or the Health Research Authority. I would be grateful to know if that was the intention of the legislation. The power to appoint the Data Guardian rests entirely with the Secretary of State, seemingly without any qualification. Is it envisaged that the Health Committee might get an opportunity to comment on such appointments? Recent appointments in the health sector have proven controversial, so it would be appropriate for the Select Committee to comment.

Our second query relates to public health commissioned through local authorities. Given the heavy use of data in public health, it is surprising that that does not seem to be covered by the Bill. Given all the public health activity undertaken by non-public bodies in recent years, I would welcome comments from the Minister and from the hon. Member for Wellingborough about whether the Bill is intended to cover health in the broader sense.

There is also a query about other forms of data that are more directly within the NHS, such as the cancer registry, which resides in Public Health England. It uses data collected by the NHS that could affect the direct care of patients. I would welcome confirmation of whether the Data Guardian is intended to cover that data, too.

The hon. Member for Wellingborough touched on clause 1 (6), which I would like to explore in a little more detail. Labour Members might have expected it to include an obligation for data controllers not only to have regard to advice, but to publish their response to that advice. That expectation is not unrealistic, given that the responses to question 5 of the Government’s consultation were overwhelmingly supportive of such a provision.

In question 5 of the consultation, the Government propose that

“organisations holding health and care data which could be used to identify individuals should be required to publish all materials demonstrating how they have responded to advice from the national data guardian.”

In their response to the consultation, the Government said:

“Responses were supportive of the proposal that the national data guardian should be given formal advice giving powers.”

That would certainly provide reassurances that the National Data Guardian will have real authority and act as an independent voice for patients, but without such statutory backing it is foreseeable that its independence and authority could be undermined. Without a requirement for organisations that receive advice to provide evidence of their response in a way that can be easily disseminated, there is no way we can be sure that the Data Guardian will be effective in doing the important job required by the Bill.

Members will recognise that the requirement for bodies to “have regard” to advice does not always mean that they take action in respect of that advice. An obvious example of that is, of course, the National Institute for Health and Care Excellence guidelines, which we know CCGs often ignore—seemingly with total impunity. I am sure Members do not want a repeat of that with this Bill, so I ask the hon. Gentleman and the Minister to respond on that point in a little more detail. I take the point that providing such responses might be burdensome on authorities controlling data, but I do not think that that cuts the mustard, given our concern about whether this measure will give the Data Guardian sufficient authority and teeth to deal with the issues under discussion.

My final point on clause 1 relates to data sharing and the lack of a positive obligation for bodies to provide that information. For the National Data Guardian to take a view on a particular data issue, it must first know that there is an issue on which to take a view—an unknown unknown, as we say. Could we have a published register of data sharing arrangements to which NHS bodies could sign up and submit a copy of their agreements? That would provide the Data Guardian with a single point of reference from which it could note any new agreements outwith the norm; that is exactly what the Government committed to doing with the current public service delivery data sharing codes of practice currently laid before Parliament.

There is a danger that the Data Guardian will become involved only after an issue has already reached the public’s attention, and possibly after an inappropriate use of data that might already have affected thousands of patients. A positive obligation to shared data arrangements with the Data Guardian might reduce the risk of such an eventuality. I look forward to hearing from the Minister and the hon. Gentleman on those points.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

It is a pleasure to serve under your chairmanship, Dame Cheryl, and an absolute pleasure to respond to the Bill of my hon. Friend the Member for Wellingborough. I congratulate him on bringing this important reform forward and thank him for working so constructively with the Government to put the National Data Guardian on a statutory footing.

This is an important reform. As the shadow Minister mentioned, the public are rightly concerned about information and data that is held on them and the extent to which that is shared. The new National Data Guardian will do much to reassure people that the environment in which data is held and managed is one that respects their privacy, while at the same time ensuring that appropriate safeguarding can be achieved. Given the culture that exists within our health services, the comfort with which organisations can respond to the advice given by the National Data Guardian will make for a much more effective system to support the public.

I confirm the Government’s support for and commitment to the Bill. We very much wish it to succeed. We see real benefits to all individuals in ensuring that we share health and care data in a safe, secure and legal way. The Bill will go a long way to increasing public trust in the appropriate and effective use of health and care data. The National Data Guardian has already established herself as an independent and authoritative voice for the patient and service user in how their data is used in the health and adult social care system.

Let me address some of the points that have been raised. Clearly, my hon. Friends will be concerned about the potential costs, as we would be as Conservatives. The estimates we have established as a result of the impact assessment provide for some extra expenditure, and that is for additional staffing so that the published guidance has a legal status—that will be a natural outcome of putting the Data Guardian on a legal footing. There will be some additional costs, and we have been generous in our estimates for them.

The shadow Minister asked a number of questions about other agencies that might be covered by the Bill, and as my hon. Friend the Member for Wellingborough said, the Bill as drafted covers public health. Provisions in the Bill will extend to local authority functions with respect to adult social care, but not to children because they are covered by a different legal framework.

The hon. Member for Rhondda raised some good points to which we could ask the National Data Guardian to have regard. He is right to say that we as Members of Parliament often take up health and social care issues on behalf of our constituents, and nothing is intended to get in the way of that. Indeed, it could be helpful to us if the National Data Guardian gave instructions to those bodies about their obligation to be open and transparent. I am sure that the hon. Gentleman, and other hon. Members, have often found that the spirit of openness that we expect when we challenge something is not always respected. In that culture of openness, and with respect for privacy and safety, we support the Bill.

[Mr Bone]

I am grateful for the support from the Minister and the shadow Minister, and I wish to pick up on a couple of points. The appointment will be down to the Secretary of State, but I absolutely expect it to go to the Health and Social Care Committee—I think that is understood. A point was raised about advice and having written reports on what is being done, but the argument against that is that we want to see action. There is some confusion—the Data Guardian is not a regulator, and therefore that is not its role. All organisations are covered by a regulator and will take into account what the National Data Guardian says. That is why I do not think that such a provision would work.

[Justin Madders]

I understand what the hon. Gentleman is saying, but it was clear in the Government consultation, and the response to it, that there was an intention for the body to have a few more teeth. Why did that change course?

[Mr Bone]

The problem is that we could easily say that we need to have a regulator, but that is not what the Data Guardian does. We do not want to come along afterwards and say what has gone wrong; we want to get this right at the beginning and work with the different holders of data. It is a different approach. The comparison I think of is when I was involved with combating modern-day slavery. We now have a commissioner for that whose job is not to regulate but to expose and say what is going well or badly, and that helps. There could be pressure on an organisation—for instance, if it gets really bad publicity it will do something about it, but equally the commissioner will show where things are going well. We do not want to move towards a regulator or have lots of enforcement powers because that is totally different to what we have already established with Dame Fiona. Each hospital has a Caldicott guardian in it, so we are basically putting something that works on a statutory footing for the future.

I am pleased by the conversion of the hon. Member for Rhondda to concerns about cost, and I shall remind him of that if there is ever a Labour Government in future—

[Chris Bryant]

When!

[Mr Bone]

Well, I am sure there will be a Labour Government sometime in the next century.

The hon. Gentleman makes a very important point about MPs and data provided by our constituents. Although I do not think it is particularly relevant to this, I do think all Members are wrestling with what the new regulations mean. Medical practitioners have to hold information for a very long time. I have very detailed medical information from some of my constituents, and serious issues might arise if we were forced to destroy such information. Perhaps the National Data Guardian could give some advice on that point. I get very frustrated when I have to deal with the local hospital, if I do not get a consent form. That is clearly a delaying factor and definitely needs to be cleared up.

Question put and agreed to.

Clause 1 accordingly ordered to stand part of the Bill.

Schedule 1 agreed to.

Clause 2

Interpretation

Question proposed, That the clause stand part of the Bill.

[Mr Bone]

We have dealt with the heart of the Bill in clause 1. The subsequent clauses, while important, are not so detailed.

The purpose of clause 2 is to define some of the important terms used in clause 1. For instance, subsection (3) defines “adult social care”. I would clarify that children’s social care data, as has already been mentioned, is not within the scope of the Bill. It is covered via a different legislative framework and that framework has safeguards in place to protect children’s social care data from inappropriate use.

I would also point out that clause 2(7) provides that “processing” has the same meaning as given in section 1(1) of the Data Protection Act 1998. That definition has been used as it is a broad definition that captures a whole range of activity involving data, including obtaining, holding, recording, using and sharing.

[Justin Madders]

I wish to raise a point on the exclusion of children’s data. I appreciate that hon. Members have referred to it already, but we are slightly concerned that although children’s data may be covered elsewhere, the guardian does not have any ability to write to bodies in that respect. It is perfectly reasonable for that to be included; indeed, I think it was included in the original Bill as drafted. We see it as a safety net, rather than an added complication.

--- Later in debate ---

[Jackie Doyle-Price]

If I may, I will come back to the hon. Gentleman on that point. I would say that it would not, but I will confirm in due course.

[Mr Bone]

The shadow Minister makes a fair point, which goes to the heart of a problem that I have found in the past—that children are looked after by the Department for Education and not the health service. When I dealt with modern-day slavery, I came across exactly the same problem. What the shadow Minister said should be heard loud and clear by the Department for Education.

Question put and agreed to.

Clause 2 accordingly ordered to stand part of the Bill.

--- Later in debate ---

[The Chair]

With this it will be convenient to discuss that schedule 2 be the Second schedule to the Bill.

[Mr Bone]

The clause introduces amendments to other legislation as a consequence of the Bill. Schedule 2 lists five Acts to be altered, following parliamentary counsel’s advice. Those are the Public Records Act 1958, the Parliamentary Commissioner Act 1967, the House of Commons Disqualification Act 1975, the Freedom of Information Act 2000 and the Equality Act 2010.

[Chris Bryant]

Why is the hon. Gentleman so keen on disqualifying a Member of the House of Commons from being the Data Guardian?

[Mr Bone]

We have taken parliamentary counsel’s advice—as always, I take advice from people. That is the reason: it is as a consequence of advice given by parliamentary counsel, and I am happy to accept that, unless the hon. Gentleman is thinking of himself in that role.

[Jackie Doyle-Price]

The consequential amendments introduced are typical for setting up such a body. The Government are content with the clause, as drafted.

Question put and agreed to.

Clause 3 accordingly ordered to stand part of the Bill.

Schedule 2 agreed to.

Clause 4

Extent

Question proposed, That the clause stand part of the Bill.

[Mr Bone]

The clause sets out the Bill’s territorial extent. The Bill extends to England and Wales only. The Committee will note that clause 1 provides for the Data Guardian to publish guidance and give advice, information and assistance, but that applies only to the processing of health and social care data in England. However, in regard to application, the provisions extend to England and Wales but apply only to England. The provisions do not extend or apply to Scotland or Northern Ireland. I hope that is perfectly clear.

[Chris Bryant]

Well no, it is not really. In fact, it is a little bit worse than that. We return to clause 2(5), which says:

“‘The health service’ means the health service continued under section 1(1) of the National Health Service Act 2006”,

but that Act states:

“The Secretary of State must continue the promotion in England of a comprehensive health service”

and so on. I therefore do not understand why the Bill extends to England and Wales. Will the provision will have any relevance whatever in Wales? If not, I do not know why it says that it does.

--- Later in debate ---

[Jackie Doyle-Price]

Clearly the Bill extends to England, but the purpose of the National Data Guardian is to give advice on the appropriate sharing of data and best practice. I should expect practitioners to have regard to the advice regardless of where they come from, because, notwithstanding the legal framework in which they operate, all health professionals want to behave in a responsible way. We expect the guidance of the National Data Guardian to be good practice. She has been giving advice without statutory powers to do so, and that advice has been respected; I think that that will continue. It is largely through an accident of the current structuring of the health service that the provisions are as they are. The principles under which the Data Guardian will give advice extend way beyond the geography of England.

[Mr Bone]

The Minister has explained that better than I could possibly do.

Question put and agreed to.

Clause 4 accordingly ordered to stand part of the Bill.

Clause 5

Commencement

Question proposed, That the clause stand part of the Bill.

[Mr Bone]

The clause provides for all the Bill’s provisions to be brought into force by regulations made by the Secretary of State. It is a standard clause to be found in many Acts of Parliament.

[Sir Christopher Chope]

It may well be a standard clause, but such clauses are often abused by the Government. For example, Parliament passed a measure to outlaw exit payments for public sector workers in the Enterprise Act 2016. We are still waiting for the regulations under that primary legislation to be introduced. The Government now say that they will have to consult on them. Effectively, what Parliament thought was happening—the limiting of public sector exit payments—has not happened.

The Bill is supported across the House, as the measure I have mentioned was. I should be grateful for some indication from the Minister of when the Government will implement it. It could be delayed by the Government by means of the regulation-making powers in the clause; or by the Government’s not appointing the Data Guardian. There are other ways in which it could be delayed, and if we take the past as a guide to the future we should be suspicious of the Government when they are not prepared to include in the Bill a commitment for it to commence on a given date.

--- Later in debate ---

[Jackie Doyle-Price]

I completely agree with everything my hon. Friend says. It is Ministers’ responsibility to ensure that the decisions made by Parliament are actioned as promptly and effectively as possible. I know him well enough to be sure that he will hold me to account on exactly that basis if he does not feel the Bill comes forward quickly enough. I would like to see it commenced by the end of the year, and I will work with my officials to ensure that that is the case. If we cannot achieve that, I will give him an explanation.

[Mr Bone]

I am grateful for the contributions by my hon. Friend the Member for Christchurch and the hon. Member for Rhondda. I absolutely agree with their general comments. I looked carefully when drafting the Bill at the issue they raised. I could have included a provision that the Bill would come into effect, say, six months after it became law, but I did not because we already have a Data Guardian, so there will not be any gap, and I know how much the Government support the Bill. That is the reason we did not put in a date, but under other circumstances I absolutely would have insisted on one.

Question put and agreed to.

Clause 5 accordingly ordered to stand part of the Bill.

Clause 6

Short title

Question proposed, That the clause stand part of the Bill.

[Mr Bone]

The clause just requires the Act to be cited as the Health and Social Care (National Data Guardian) Act 2017.

--- Later in debate ---

[The Chair]

Before I close proceedings, may I thank all Members for taking part in the scrutiny of the Bill, and the Hansard reporters and officials from both the House and the Department who have supported us?

[Mr Bone]

On a point of order, Dame Cheryl. I thank you very much for chairing the Committee and all Members for their participation, which is much appreciated.

[Jackie Doyle-Price]

Further to that point of order, Dame Cheryl. I echo the thanks of my hon. Friend and again thank him for his real industry on what will be an important reform. I also thank colleagues who showed up today for their probing questions, which are always important as we scrutinise legislation.

Health and Social Care (National Data Guardian) Bill (Money)

Peter Bone Excerpts

Money resolution: House of Commons
Monday 21st May 2018 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I beg to move,

That, for the purposes of any Act resulting from the Health and Social Care (National Data Guardian) Bill, it is expedient to authorise the payment out of money provided by Parliament of any expenditure incurred under the Act by the Secretary of State.

I pay tribute to my hon. Friend the Member for Wellingborough (Mr Bone) for bringing forward this important Bill. I once again confirm the Government’s support for and commitment to it and our desire to see it succeed.

[Mr Peter Bone (Wellingborough) (Con)]

rose—

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

I was going to let the shadow Minister come in first, Mr Bone.

--- Later in debate ---

[Mr Peter Bone (Wellingborough) (Con)]

I am grateful to the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), for what he has said about the Bill. I completely understand his closing remarks, and I will try to deal with that dilemma later. It is very strange that a money resolution should be proposed for Bill No. 94 before one has been proposed for Bill No. 9. I also thank the excellent Minister—I think that we may be meeting tomorrow to discuss the Bill—for introducing the motion.

We had a long debate earlier today, which was technically about money resolutions following Second Readings. It was not particularly concerned with the Parliamentary Constituencies (Amendment) Bill, but Members became carried away on that subject. What we should be doing tonight is deciding whether the expenditure for my Bill justifies a money resolution, but I can understand why Opposition Members—and, perhaps, some Conservative Members—feel that we should not pass the motion because it would leapfrog a Bill on which there was a substantive debate in the House and a very large vote. My Bill was given a Second Reading only because of the widespread support that it had attracted; there was no debate on it whatsoever. I therefore find myself in something of a dilemma over what course I should recommend to Members later.

Let me, however, explain what the Bill is about. The role of health and social care national data guardian has already been established, but the Bill would put it on a statutory footing. I thought that the need for a money resolution was a little arguable, as the Government were already paying for the same services, but the excellent advice from the Clerks was that we did need one, and the amount of money involved is reasonably substantial.

[Philip Davies (Shipley) (Con)]

I am grateful for what my hon. Friend said because I am, as he knows, one of the supporters of his Bill, so I am very grateful that we have got to this stage, too. It is said that the cost will be approximately £700,000. Does my hon. Friend think that is a fair estimate, or does he have a different view of the cost of the Bill?

[Mr Bone]

I am grateful for my hon. Friend’s intervention, but I would like to deal with that later in my remarks.

There is the following deferred Divisions motion on the Order Paper in the name of the Prime Minister:

“That, at this day’s sitting, Standing Order No. 41A (Deferred divisions) shall not apply to the Motion in the name of Mel Stride relating to the Health and Social Care (National Data Guardian) Bill.”

That is interesting because under Standing Order No. 49 automatically there has to be a debate of up to 45 minutes on a money resolution, so I am not sure why that motion is on the Order Paper. The new version of Standing Orders published on 1 May is in the Vote Office today, and consideration of such a resolution automatically can go through the moment of interruption.

[Sir Christopher Chope (Christchurch) (Con)]

We have just allowed a money resolution to go through on the nod in relation to the Tenant Fees Bill and I think the sums involved are much higher than £700,000, yet under Standing Orders we were not allowed any separate debate on that. Can my hon. Friend explain why his Bill for £700,000 has 45 minutes but a much more expensive Bill has nothing?

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

I do not think we need to consider that.

[Mr Bone]

Mr Deputy Speaker, I wanted to get credit for the fact that some years ago I got the House to accept that in Second Reading debates we can deal with the money resolution; that is perhaps my only achievement in Parliament. But it is right that if the money resolution does not follow Second Reading immediately there has to be a 45-minute debate, and the Department of Health and Social Care estimate of the cost is £700,000.

[Richard Graham (Gloucester) (Con)]

Up to that sum.

[Mr Bone]

No, the Department has estimated that these costs will be approximately £700,000 per year, so actually I suppose they could exceed that. To me, that is quite a lot of money. We have to make sure we know what we are doing tonight and I will leave it to Members to decide.

It is only fair to say that I can understand why Members might want to oppose this money resolution. It is not necessarily because they are against this Bill, but it does stop the Parliamentary Constituencies (Amendment) Bill having much chance of making progress. That is because on certain Fridays private Members’ Bills have priority if they have come out of Committee, and if we pass the money resolution on my Bill tonight I will probably take 26 October while another Bill that has already gone through will take the November slot; there are no more dates available for private Members’ Bills. I can therefore understand why Members might want to vote against this money resolution tonight, and if they did, I would respect that.

[Philip Davies]

Is my hon. Friend saying that if we vote for this money resolution this evening, the Parliamentary Constituencies (Amendment) Bill of an Opposition Member would not be able to proceed?

[Mr Bone]

That is exactly what I am saying, because it would come on as a second Bill and therefore, as it is quite a complex Bill, would not get through. I think that some people who may have been involved in rearranging when money resolutions come through—this new idea of having a choice in relation to money resolutions—were aware of that fact, but I am not sure that everyone in this House was. I considered standing up and recommending that Members should not support this money resolution. However, if I did that, I would be playing into the Government’s hands, because that would stop a private Member’s Bill.

[Sir Christopher Chope]

My hon. Friend seems to be saying—in his typically generous way—that, for the greater good, he would be prepared to make a short-term sacrifice in respect of his own Bill. From the debate that took place earlier today, we know that one way of avoiding the problem that he encounters by having to have a money resolution debated and voted on in the House tonight would be to have a Bill without a money resolution. When he drafted his Bill, did he consider whether it would be possible to draft it in such a way that it would not require any more public money?

[Mr Bone]

Absolutely. There was much discussion with the Clerks of the House on that point. As my hon. Friend knows, that money has already been expended on the system that we have. My Bill is actually not going to cost the public purse any more money than at present. I argued strongly that my Bill should not have a money resolution, but the Clerks persuaded me that it was the proper thing to do. I think they felt that, on balance, it was safer to do it like this.

I did not think I would be speaking about a money resolution for my Bill. I did not think that anyone would spend any time on this matter. What normally happens—[Interruption.] No, I think we need to scrutinise this properly—

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

Order. There is someone else who wishes to speak as well.

[Mr Bone]

I do apologise, Mr Deputy Speaker, but I think that we have 45 minutes, whatever happens.

I have lost my thread a bit, but the fact is—

[Philip Davies]

Start again if you have lost your thread.

[Mr Bone]

Well, what I am trying to say is that, yes, there is £700,000 of expenditure but we are already paying £700,000 so I am not actually asking for any more money.

I also have a gripe about the time it has taken to get this money resolution here. I am not going to thank the Government for doing this, because I think that that is wrong. This should happen automatically. It is weeks and weeks since the Parliamentary Constituencies (Amendment) Bill had its Second Reading, and that was on exactly the same day that my Bill had its Second Reading. Mine was afterwards. I think there is something a little bit shifty here. I know that other Members want to speak, so let me just say that I want a money resolution and I want my Bill to move forward, but I will quite understand if the House divides tonight as a matter of principle.

NHS Winter Crisis

Peter Bone Excerpts

Monday 8th January 2018 Commons Chamber

[Mr Speaker]

Order. It might be helpful to the House if I inform Members that I am looking to move on to the second urgent question at no later than 4.30 pm, so inevitably some people will be disappointed on this question. The longer each question and answer takes, sadly, the more people will be disappointed. I am in favour of fewer disappointments. I am sure that colleagues share that ambition with me, not just in general, but including in terms of its implications for their own question.

[Mr Peter Bone (Wellingborough) (Con)]

Does the Minister agree that the social care system is broken and that the leader of the Liberal Democrats is right that we are not going to solve the problem unless we all work together?

[Mr Dunne]

I do not think my hon. Friend will be surprised if I say no, I do not agree that the system is broken. I do accept that it requires more funding, and that is why more funding was provided. It also requires local authorities to work more closely alongside the NHS to try to share these problems and find solutions together.

Children’s Oral Health

Peter Bone Excerpts

Tuesday 31st October 2017 Westminster Hall

[Several hon. Members rose—]

[Mr Peter Bone (in the Chair)]

Order. It might help the House to know that the wind-ups should start at about 10.30 am and seven Back Benchers are trying to catch my eye. I do not intend to impose a time limit, but perhaps Members will be aware of that.

--- Later in debate ---

[Sir Paul Beresford]

On a point of order, Mr Bone. I was so enthusiastically carried away by the opening speech that I cannot remember whether I declared that I am a very part-time dentist. If I did not, I have now done so.

[Mr Peter Bone (in the Chair)]

I think hon. Members knew that, but thank you for putting it on the record. We have got about half an hour to go, and five Back Benchers wish to speak. I work that out to be roughly six minutes each.

--- Later in debate ---

[Julie Cooper (Burnley) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Bone. I am grateful to my hon. Friend the Member for Birmingham, Selly Oak (Steve McCabe) for bringing this important issue to the House’s attention. This debate is long overdue, as has been said by Members on both sides of the House. There is much agreement, and it has been really useful to hear from experts in the field—our dental and paediatric colleagues in particular.

We cannot say too loudly or too often how shocking the current state of affairs is. The hon. Member for South West Bedfordshire (Andrew Selous) quite rightly said that we have a health emergency. We cannot stress too often the truly shocking statistics that have been touched on. The biggest cause of hospitalisation for five to 10-year-olds in England—bigger than broken arms, asthma, appendicitis and all the other things that we think about children being taken to hospital for—is teeth extractions. Up to 160 children a day are undergoing general anaesthetics in our hospitals for what is preventable, and a quarter of all our five-year-olds have decaying primary teeth. In some areas of the country the situation is far worse. Deprived children are seven times more likely to suffer from tooth decay than their peers. Indeed, in some areas of Lancashire, 56% of children are affected.

Another shocking statistic I came across in preparation for the debate relates to the shortage of dentists. The hon. Member for Erewash (Maggie Throup) rightly said that NHS dental checks are free for under-18s, but accessing an NHS dentist is not easy in many parts of the country. Only this week, Cornwall has reported a backlog of 14,000 people waiting to access an NHS dentist. Some people are having to travel 70 miles to see a dentist.

What effect is that having? We have heard extensively from Members of all parties about the effect on children. There is obviously suffering in terms of the pain of dental decay, and we have heard about the effects on childhood confidence. We have also heard about time lost from school. This goes beyond the suffering of children. We cannot afford to ignore the issue, given its effect on our economy. Even if we wanted to ignore the effect on our children—I am sure none of us does—all the evidence suggests that last year 1.2 million working days were lost as parents took time out of work to care for children who had oral health issues.

Of course, we cannot ignore the pressures on the NHS. We hear every week in this House about funding issues in the NHS and how it does not have the funding it so desperately needs. This preventable issue costs the NHS £5 million a year. That cannot go on—it makes no sense.

What are the answers? There are no quick fixes. Many Members have raised interesting ideas, and I think the answer lies in a combination of them. I hope the Minister will talk about his plans to reform the dental contract and that that will result in a dental contract in England that has prevention and public health at its heart and that builds in an element of sustainability for dental practices. I hope we will adequately fund more dentists. There is a massive shortage of NHS dentists, and Health Education England has cut funding to train dentists by 10%. Dentists have raised concerns with me about that this week. In particular, 17% of our NHS dentists come from the EU, and agencies that supply them to our NHS are already reporting a 90% fall in EU-citizen dentists willing to sign up to support our NHS.

As has been said, we desperately need a public health education programme. It was heart-warming to hear about the work done in Scotland through the Childsmile programme. I would like to see us go further in England, and I hope the Minister will assure us on that. It could be done in an affordable fashion by reinvesting the savings and ensuring that every health professional—everyone who comes into contact with a child from their earliest days, such as the midwife—plays a part in making sure that parents fully understand the oral needs of their children. We must ensure that every nursery schoolteacher is reinforcing that message. And, yes, in the same way as has happened in Scotland, and in some cases in Wales, toothbrushes and toothpaste, as well as fluoride washing, should be provided in the more deprived areas. We have heard about the positive impacts that fluoridisation can have, but that in itself is not an answer.

The wider benefits are hard to measure, but the impact on the NHS and on child wellbeing is crucial. As the chair of the British Dental Association said:

“These shocking statistics are rooted in an abject failure by government to tackle a preventable disease.”

I look to the Minister to assure us on those points and to tell us that we will go beyond pilots. As many Members have said, the evidence is there. This is an urgent situation. For the sake of our children, our NHS and the wellbeing of future generations, we need to tackle this as a matter of urgency.

[Mr Peter Bone (in the Chair)]

Before I call the Minister, I remind him that the convention is to let Mr McCabe wind up at the end.