Monday 27th January 2020
(4 years, 2 months ago)
Commons ChamberRead Hansard Text
This text is a record of ministerial contributions to a debate held as part of the NHS Funding Act 2020 passage through Parliament.
In 1993, the House of Lords Pepper vs. Hart decision provided that statements made by Government Ministers may be taken as illustrative of legislative intent as to the interpretation of law.
This extract highlights statements made by Government Ministers along with contextual remarks by other members. The full debate can be read here
This information is provided by Parallel Parliament and does not comprise part of the offical record
The Secretary of State for Health and Social Care (Matt Hancock)
I beg to move, That the Bill be now read a Second time.
With your permission, Madam Deputy Speaker, before turning to the Bill I would like to update the House on the ongoing situation with the Wuhan coronavirus. The chief medical officer continues to advise that the risk to the UK population is low and that, while there is an increased likelihood that cases may arise in this country, we are well prepared and well equipped to deal with them. As of 2 pm, there are currently no confirmed cases in the UK. We are working night and day with the World Health Organisation and the international community and are monitoring the situation closely. Our approach has been guided by the chief medical officer, Professor Chris Whitty.
As I set out in my statement on Thursday, coronavirus presents with flu-like symptoms including fever, a cough and difficulty breathing, and the current evidence is that most cases appear to be mild. However, this is a new disease, and the global scientific community is still learning about it. I have therefore directed Public Health England to take a belt-and-braces approach, including tracing people who have been in Wuhan in the past 14 days. Coronaviruses do not usually spread if people do not have symptoms. However, we cannot be 100% certain.
From today, as concerns have been raised about limited pre-symptom transmission, we are asking anyone in the UK who has returned from Wuhan in the last 14 days to self-isolate—to stay indoors and avoid contact with other people—and to contact NHS 111. If you are in Northern Ireland, you should phone your GP. If you develop respiratory symptoms within 14 days of travel from the area and are now in the UK, call your GP or ring 111, informing them of your symptoms and your recent travel to the city. Do not leave home until you have been given advice by a clinician.
Public Health England officials continue to trace people who have arrived in the UK from Wuhan. Having eliminated those who we know have since left the country, we are seeking to locate 1,460 people. The Foreign Office is rapidly advancing measures to bring UK nationals back from Hubei province. I have asked my officials to ensure that there are appropriate measures in place upon arrival to look after them and to protect the public. If you are in Hubei province and wish to leave, please get in contact with the Foreign Office; there are details on the gov.uk website.
The UK is one of the first countries in the world to have developed an accurate test for this coronavirus, and PHE is undertaking continuous refinement of that test. PHE has this morning confirmed to me that it can scale up, so we are in a position to deal with cases in this country if necessary. I want to stress that the NHS remains well prepared. The NHS has expert teams in every ambulance service and at a number of specialist hospital units with highly trained staff and equipment, ready to receive and care for patients with any highly infectious disease, including this one. The NHS practises and prepares its response to disease outbreaks and follows tried and tested procedures, following the highest safety standards possible for the protection of NHS staff, patients and the public. Specific guidance on handling Wuhan coronavirus has been shared with NHS staff.
This is a timely reminder of why it matters to have a world-class healthcare system—to be able to plan and prepare for such situations.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
I am grateful to the Secretary of State for updating the House and for letting me intervene at this point, before we move on to the substance of today’s debate. First, could he offer some further clarification? According to the newspapers, there are suggestions that France, the United States and Japan are airlifting their citizens out of Wuhan tomorrow. I emphasise that I am going off newspaper speculation and I appreciate that that is not his portfolio, but how advanced are the Foreign Office’s plans? Secondly, could he update the House about whether it is correct that the treatment of coronavirus would need a number of extra corporeal membrane oxygenation beds to be open? ECMO beds are in high demand in winter. Could he update the House on how many ECMO beds are currently open, and on what preparations the NHS is making on that front?
Matt Hancock
The Foreign Office is working with international partners both in America and other EU countries, keeping open about the procedures and what it will do for the estimated 200 UK citizens who are in the area in China in which this is currently contained. On the point about the readiness of the NHS here, four centres are stood up and ready should there be a need. The centres are in Guy’s and St Tommy’s, Liverpool, Newcastle and the Royal Free, and there is a further escalation if more beds are needed. So we are ready, but of course we keep all these things under review.
Geraint Davies (Swansea West) (Lab/Co-op)
The Secretary of State will know that we are all looking forward to lots of celebrations of the Chinese new year. What communication has he had with Chinese organisations that are arranging these, so that they can get in contact with people who may have come from Wuhan so as to try to identify risk and pre-empt problems?
Matt Hancock
We are using all possible means to get in contact with the 1,460 people whom we need to contact, and who we know have travelled to the UK from Wuhan and who have not as far as we know left the country. We are collaborating with Border Force, the airline and others, including universities, schools and cultural organisations to try to make contact.
Seema Malhotra (Feltham and Heston) (Lab/Co-op)
My constituency borders Heathrow, and many of my constituents will be working at Heathrow with the airlines and in many other roles. I appreciate that the risk may be low, but could the Secretary of State update the House on whether advice has been given to Heathrow and airlines on how to give advice to their staff who may have come into contact with people who might be affected so that everybody can be assured that all is being done and that any support they may need is available?
Matt Hancock
The hon. Member is quite right to raise this. There is a Public Health England unit or hub at Heathrow to meet all flights from China now; it met the one flight that has come from Wuhan directly since news of this outbreak reached the level it did last Wednesday. The advice is clear to anybody who is worried about having coronavirus, and that is to call 111. If they have travelled to Wuhan or elsewhere in China recently, they should declare that to the 111 service when they call, and the 111 service has the full advice available. It is important for them to call 111 or to call their GP rather than going to a GP or to A&E, for exactly the reason that we want people to self-isolate if they have been to the region or if they think that they may have the virus.
I will now move on to the Bill. As we have been highlighting with the NHS work on the coronavirus that originated in Wuhan, few things in life are certain. However, it is the job of Government to plan for the future, even though we cannot fully see it. We do not know for instance exactly how many babies will be born in four years’ time, but we can anticipate demand for maternity services. We do not know exactly how many people will make a 999 call in four years’ time, but we can and must plan for that. Indeed, we do not know if the Labour party will have a competent leader in four months’ time, let alone four years’ time, but I hope for the country’s sake to see the hon. Member for Leicester South (Jonathan Ashworth) on the Opposition Front Bench well into the next decade. There is one institution that, with this Bill, knows it will get the funding it needs in 2024, and that is the NHS, because this Bill injects the largest and longest cash settlement ever granted to the NHS and will enshrine it into law—£33.9 billion extra a year by 2024.
Robert Halfon (Harlow) (Con)
Does not this excellent Bill ensure that people will never again be misled into thinking that we are selling off the national health service to Donald Trump? Does the Secretary of State also agree that the money guaranteed in this funding Bill will ensure that places such as Harlow will have a new hospital, as has been guaranteed by my right hon. Friend?
Matt Hancock
Yes, I am delighted to be able to assure my right hon. Friend that, on both counts, he is absolutely spot-on. This Bill makes it clear that we will be funding the NHS with its long-term plan and making this long-term commitment as a minimum. The election result put paid to the scaremongering put about by Opposition Members in relation to the NHS in trade deals, because the NHS is not on the table. When it comes to Harlow, my right hon. Friend and the people of Harlow well know that I am delivering: we will have a new hospital in Harlow.
Sir Geoffrey Clifton-Brown (The Cotswolds) (Con)
On the same theme as that raised by my right hon. Friend the Member for Harlow (Robert Halfon)—privatising the NHS—will the Secretary of State confirm that the disastrous private finance initiative deals done by the last Labour Government were not only the largest privatisations the NHS has ever seen, but that they cost various NHS trusts billions of pounds? Will we be reversing that, and will the money go into the local NHS trusts?
Matt Hancock
Yes and yes; my hon. Friend anticipates my whole section on Mr PFI sitting over on the Opposition Front Bench. During his time in the Treasury, the hon. Member for Leicester South, managed to sign off some of the worst PFI deals. [Interruption.] The hon. Gentleman sighs, but I do not think he understands the damage he has done.
This Bill confirms that spending on the NHS will rise from £115 billion last year to £121 billion this year, to £127 billion, then £133 billion, £140 billion and £148 billion in 2023-24.
Dr Philippa Whitford (Central Ayrshire) (SNP)
To clarify the point, are the Government committed to buying out the PFIs that are currently a burden on health boards and trusts?
Matt Hancock
We absolutely will be looking at doing that where we can. Unfortunately, that is difficult to do, because, over time, and especially during the time that the hon. Member for Leicester South was in the Treasury, the legals on these PFI deals got tighter and tighter. There are 106 PFI deals in hospitals and we are going through them. We will work towards making them work better for patients, and if that means coming out of them completely, I will be thrilled.
Sir Bernard Jenkin (Harwich and North Essex) (Con)
My right hon. Friend might know that I am a vice-president of Combat Stress, the charity for the mental welfare of our armed servicemen and veterans. Until recently it had a very tiny contract compared to the vast sums he has just announced—£3.1 million a year—and was treating some 250 patients a year with PTSD and other mental illnesses related to combat stress. Combat Stress is now having to discontinue taking referrals because the contract has come to an end. What prospect is there that there will be a new contract as soon as possible so Combat Stress can carry on its brilliant work?
Matt Hancock
I am very glad that my hon. Friend has raised this matter, because I was concerned to read the reports in the newspapers and have had a briefing this morning. There is work on a new contract to replace the old one, and I very much hope that that is settled and agreed as soon as possible.
Dean Russell (Watford) (Con)
First, I thank my right hon. Friend the Secretary of State for visiting Watford during the election, when he came to Watford General Hospital with me and very kindly met the chief executive. As part of that, he assured me that we would get £400 million of investment from the Government for West Herts trust, primarily to secure a new Watford General Hospital, one of six new hospitals—and many more—over the next few years. Given press speculation about the money being a loan and not funding from the Government, will he reassure my Watford constituents that that is not the case?
Matt Hancock
Yes, that is exactly right. I enjoyed visiting Watford at the invitation of my hon. Friend. It is fantastic that Watford will get a new hospital. Watford General Hospital needs to be rebuilt and it will be rebuilt with a grant from the Government. The money will go to Watford general—to the trust—as he mentions. It will not be a loan; it will be a grant. I know that there has been some speculation about that. I do not know where it came from, but it is not true. The money will come as a grant.
Several hon. Members rose—
Matt Hancock
Let me make a little progress, because so many people want to speak.
The purpose of the Bill is to set a minimum amount for the money going into the NHS. I want to set out what the funding in the Bill will be used for and what it will pay for, and also what we are adding on top of that, because the distinction is important.
Jim Shannon (Strangford) (DUP)
The Minister heard earlier from another Member about mental health issues, which do not just affect adults but also affect children—those from 10 to 12 or in their teenage years. A great number of children suffer from mental health issues at school. What has been done to help those schoolchildren to address those issues, which needs to happen early?
Matt Hancock
The hon. Gentleman is right to raise what is an incredibly important issue. We are rolling out support for mental health practitioners in schools across England. We have just given the new devolved Northern Ireland Government a big funding increase to enable them to roll out those services. Obviously this is a devolved issue, so exactly how they do that is up to them, but we will ensure that the roll-out continues across England and that children get the support they need.
Marco Longhi (Dudley North) (Con)
Having worked in the health economy for a couple of decades, I know that commissioners and providers will be absolutely delighted at the long-term approach that my right hon. Friend is taking to revenue funding of the NHS. However, patient experience and patient outcomes also rely on the delivery of capital projects, not least at Russells Hall Hospital in my constituency, where we really need extra capacity, not least in A&E and our car parks. Will my right hon. Friend or one of his Ministers meet me to discuss these issues?
Matt Hancock
Yes, of course. The Minister for Health, my hon. Friend Member for Charnwood (Edward Argar), is responsible for the roll-out of additional capital for car parks, which we committed to in the manifesto. More broadly, we will both be very happy to talk to my hon. Friend about what more we can do for Dudley. It is incredibly important, and he is already such a powerful advocate for it.
Several hon. Members rose—
Matt Hancock
I will give way to the hon. Member for Swansea West (Geraint Davies) and then the hon. Member for Nottingham South (Lilian Greenwood).
Geraint Davies
The Secretary of State knows that NHS funding increases in recent years have averaged about 1.4%. His plan is for 3.4%, yet the last Labour Government delivered average increases of 6% a year—almost twice as much—so how can he be saying that this is enough? It is clearly too little, too late.
Matt Hancock
No, it is the largest and longest funding settlement in history, and we can fund a strong NHS only if we have a strong economy. We had this debate during the general election, and the general public saw straight through promises that cannot be funded because of other policies that would crash the economy. We will fund the NHS properly. This Bill places a legal duty on the Government to uphold a minimum level of NHS revenue funding over the next four years. This point is very important. The legislation explicitly states that the Bill establishes a floor, not a ceiling, for how much we spend on our vital and valued public service and on the revenue budget, which means the day-to-day running costs of the NHS.
Vicky Ford (Chelmsford) (Con)
One of the fantastic things that we have seen in the NHS in the past few years has been the opening of new medical schools, such as the one in my constituency—I refer to my entry in the Register of Members’ Financial Interests and declare that I am now on the board. Will some of the new funding go into more training, in particular training of more nurses?
Matt Hancock
The funding for training more nurses comes on top of what is in the Bill—the Bill is for the day-to-day running costs of the NHS—and it has already been committed to. The Bill will help us to create 50 million more GP appointments every year so that we can reduce the time that people have to wait to see their GP. It will help to pay for new cancer screening and faster diagnosis so that we can save tens of thousands of lives of people suffering that terrible disease. It will help to pay for the prevention, detection and treatment of cardiovascular disease so that we can prevent over 100,000 strokes and heart attacks. At its heart, the funding will help us to create more services in the community, closer to home, with pharmacies playing a much bigger role. For the first time in a generation, the proportion of NHS funding going to primary and community care will increase, shifting resources to the prevention of ill health, because prevention is better than cure.
James Cartlidge (South Suffolk) (Con)
My right hon. Friend and neighbour talks about how we pay for the NHS, and he said that we cannot know what will happen in future, but does it give him good heart that in the last 24 hours, Ernst and Young has predicted that our growth will be higher than expected on the back of the election of a Conservative Government, which we all have confidence will deliver the growth that we need to fund the NHS?
Matt Hancock
Yes. That just shows how sensible the British people were to elect a majority Conservative Government. The funding will also allow the NHS to invest in innovative technology, such as genomics and artificial intelligence, to create more precise, more personalised and more effective treatments. That will help the life sciences industry, which is one of our fastest growing industries, and in turn, help to support growth.
Grahame Morris (Easington) (Lab)
I want to make a point about new technologies and what is not in the Bill—namely, capital and training budgets. That is vital to address our woeful performance on cancer outcomes, which I want to touch on in more detail later. Specifically, what will the Secretary of State do about the under-investment in advanced radiotherapy? We are spending £383 million but we should be spending considerably more if we are going to provide a world-class service.
Matt Hancock
The hon. Gentleman is absolutely right that we need earlier diagnosis of cancer—I entirely agree. Rolling out the 200 extra diagnostics facilities and increasingly making them available in the community, rather than just in big hospital centres, is an absolutely mission-critical part of that. The funding will also allow us to upgrade our outdated frontline technology—that is tied to what he just called for—which will save time for staff and save the lives of patients. Within the financial settlement, mental health spending will increase the fastest so that we can transform how we prevent, diagnose and treat mental ill health across the country. Within that allocation, funding for children’s mental health will go up faster still.
Ian Paisley (North Antrim) (DUP)
I welcome the points that the Secretary of State has just made, particularly on Northern Ireland. As he knows, Northern Ireland has the most disastrous waiting lists. Will he commit to keeping his eye on what is happening in Northern Ireland even though there is a devolved settlement, because clearly the eye has been taken off the ball and patients are suffering?
Matt Hancock
The hon. Gentleman is absolutely right that the three years without an Administration in Northern Ireland have led to all sorts of difficulties. I have already spoken to my new Northern Ireland counterpart twice and offered all the support that we can give. The extra funding will help an awful lot, but it is sadly true that there are over 10,000 people waiting more than a year for a procedure in Northern Ireland. The number in Wales—run by the Labour party—is over 4,000, and the number in England is just over 1,000. We have to make sure that we get the very best treatment across the whole of the UK. Even though I am responsible for the NHS in England, I am also the UK Health Secretary. For instance, on the public health emergencies that we have been talking about recently, we have to engage across all four nations and make sure that the Northern Irish health system improves, as do the Welsh system—which is in a terrible state in many places, despite the amazing effort of the staff who work in it—and the problems that we well know about in the Scottish system.
Lilian Greenwood (Nottingham South) (Lab)
The Secretary of State has set out many commitments relating to what he wants to deliver with the extra funding in the Bill. However, the funding in the Bill is purely in cash terms. Will he make a commitment here and now that if inflation rises, such that £33.9 billion does not equal £20.5 billion in real terms and therefore does not deliver the real-terms increase that he has promised, he will exceed the amounts that are set out in the Bill?
Matt Hancock
We are already exceeding those amounts with the additional funding that I mentioned to do with training and capital, both of which are critical. Of course the budget is set out in cash terms: cash is what the NHS spends. Part of what the NHS has to do is make sure that it spends the money getting the best possible value for money. I am acutely aware that, while we are spending £33.9 billion extra and the total budget is almost £150 billion, every single pound of that is taxpayers’ money. We have to be acutely aware of the value we get from it.
Sir Desmond Swayne (New Forest West) (Con)
We have said that there will be parity of esteem between mental and physical health. What is the mechanism for ensuring that the money that my right hon. Friend has announced is actually spent on mental health, as desired, rather than elsewhere?
Matt Hancock
That is clearly set out in the operational guidance to the NHS—that it must be. That will be auditable, and I am sure that my right hon. Friend will look to ensure that that has happened. This is an issue where the levers from the Secretary of State’s office to the NHS frontline are extremely well connected.
Richard Drax (South Dorset) (Con)
One way to ensure that patients can be best served is to make the software more compatible, and I know that my right hon. Friend is doing a huge amount to make that happen. Can he brief the House about where we are when it comes to making the system more compatible throughout the whole UK?
Matt Hancock
Yes. My hon. Friend makes a really important point. The issue is not just the quantity of money but how we spend it. Making sure that we get the best value for every pound put in is incredibly important. One way to do that is by using the best modern technology—ensuring that the different systems are required to talk to each other, for instance. We will be introducing a system with standards of interoperability mandating that the only systems that can be used are those that allow the information—appropriately and with appropriate privacy safeguards—to flow between different NHS organisations. People have had the experience so many times of informing one part of the NHS about what is going on and having to say everything all over again to another part of it. I want to end that.
Several hon. Members rose—
Matt Hancock
I want to finish this section, Madam Deputy Speaker. The crucial thing in this Bill is the certainty: the Bill provides everyone in the NHS with the certainty to work better together to make long-term decisions, get the best possible value for money, increase the productivity of the NHS and improve how the health system is organised and delivered. That is not just tied to what has been done in the past, but is driven by a clear view of what the NHS needs to do in future, exactly as my hon. Friend the Member for South Dorset (Richard Drax) said.
Patrick Grady (Glasgow North) (SNP)
If the Secretary of State is so proud that these figures represent a floor and not a maximum, why have the Government tabled such a restrictive money resolution? It means that it will be impossible for Members to table their own suggestions about higher amounts—bringing UK health spending in line with per capita spend in Scotland, for example, despite the fact that the Bill is subject to the English votes procedure.
Matt Hancock
I would be careful about making that argument if I were the hon. Gentleman. Over the last decade, the Scottish Government have increased spending on their NHS slower than we have in England. I will not take second best—I will not take the retrograde Scottish National party attitude. No wonder the SNP bangs on so much about its dream of breaking up this country—it cannot defend its record on the NHS.
Mr Robert Goodwill (Scarborough and Whitby) (Con)
The Secretary of State has already mentioned the 50 million additional GP appointments, but are not 13 million GP appointments and 6 million nurse practice appointments already missed annually—not to mention the people turning up at A&E who are neither accidents nor emergencies? Can we do more to make sure that the money spent is spent more effectively?
Matt Hancock
Yes, absolutely. If we use technology to set up a better booking system for GPs, it turns out that we reduce by a third the number of times people do not attend.
Matt Hancock
Somebody on the Opposition Front Bench just shouted, “Oh, come on!” when I talked about saving huge amounts of money by reducing by a third the number of people who do not attend a GP appointment. They should get with the programme, and use the best technology to support our staff in the NHS.
Andrew Bowie (West Aberdeenshire and Kincardine) (Con)
My right hon. Friend brought up the issue of Scottish funding. Does he share my regret and frustration that if the Scottish Government had matched our funding at the levels that we are spending in England, the NHS in Scotland would have £505 million more to spend on frontline services? The fact is that they are investing more slowly, and less, than we are south of the border.
Matt Hancock
Exactly. That is precisely true, and what is so frustrating is this—perhaps my hon. Friend knows the answer to this question: what did they do with the half a billion pounds that they did not put into their NHS? It is a disgrace.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
As well as the question of what the money will be spent on—and I welcome the extra investment—there is the question of—[Interruption.]
Matt Hancock
I am glad that you gave us a chance to listen to the hon. Lady, Madam Deputy Speaker, because that was a very important intervention. Life expectancy is rising, but I will not accept rising inequality in life expectancy, and the hon. Lady should expect that to be a major focus of our work in the Department when it comes to where the money goes.
Several hon. Members rose—
Matt Hancock
I need to make some progress.
Let me turn to what is happening on top of the funding in the Bill. The revenue budget does not cover the budgets for training and for infrastructure investment, so the increase in the training budget and the money for new infrastructure will be in addition to the £33.9 billion for the core day-to-day running costs. We made clear in the manifesto that we would have more nurses in the NHS—50,000 more—and I am delighted that the latest figures, released last week, show an increase of 7,832 over the last year,
Matt Hancock
If the hon. Lady wants to welcome that increase of over 7,000, she is more than welcome to do so.
Janet Daby
I thank the Secretary of State for giving way, and of course I welcome more nurses in our NHS. Why wouldn’t I? My mum was a nurse in the NHS. However, I want to ask the Secretary of State about the increase for the recruitment and retention of mental health nurses, and whether he will agree to ring-fence new mental health funding to ensure that it goes to the Department to which it is meant to go.
Matt Hancock
I can guarantee that the mental health funding will be ring-fenced; and I want us, from the House, to pay tribute to the hon. Lady’s mum.
We are going to have more nurses, and I am delighted that we already have a record number of registered nurses, a record number of midwives, a record number of nursing associates and a record number of nurses in training. If the current trends continue, 36,000 nurses will join the NHS each year from the domestic and overseas workforce, which means that we will have more than 140,000 new nurses by 2024. However, we need more nurses now, and we will have 50,000 more by the end of this Parliament. That is a critical manifesto commitment on which we intend to deliver.
We need the right number of nurses and we need them to have the right skills, with nursing increasingly becoming a highly skilled as well as a caring role. From September this year, we will give every student nurse a training grant worth at least £5,000 to support them in their studies and ensure recruitment and retention. We are also expanding the routes into nursing with more nursing associates and nursing apprenticeships, making it easier to climb the ladder to become a fully registered nurse, and prioritising the care of our nursing staff to encourage more of them to stay in the NHS.
Of course, that training grant will also apply to midwives, paramedics, dieticians and all allied health professionals. Too often, the media use “doctors and nurses” as shorthand, and sometimes, if I am honest, we do that in this House, too. We should instead recognise the essential contribution of our allied health professionals, without whom our NHS family is incomplete and on whom our increasing move to multidisciplinary teams depends. This £2 billion training package is in addition to the funding contained in this Bill.
Finally, as well as revenue and training, the NHS also needs more money for infrastructure. On that point, I will give way to the hon. Member for Rhondda (Chris Bryant).
Chris Bryant (Rhondda) (Lab)
My question is not about infrastructure. It is about the Secretary of State’s last paragraph, on the training element. He referred to the fact that we often refer just to “doctors and nurses”. Actually, radiologists are absolutely vital to ensuring, first, that you get a swift diagnosis of cancer and, secondly, that you get swift and proper treatment for it. The Royal College of Radiologists reckons that we will be 2,000 radiologists short by 2023. How are we going to fill that gap?
Matt Hancock
As in so many other areas, we are hiring. My response to hearing about problems of shortages is, of course, to use all the tools available to ensure that we help those who are currently working in the NHS—for instance, with new technology—but also to hire and train more.
Steve Brine (Winchester) (Con)
My right hon. Friend will know that, as well as financial clout from No. 11, it is important to have political will from No. 10 around prevention. He has mentioned this already, but can he assure me that during this new Parliament we will focus relentlessly on prevention, and especially on the obesity challenge? Obesity is leading to preventable cancers, and we did so much good work in the last Parliament—some of which I did with my right hon. Friend—so will he please double down on this? It is so important that we prevent the illnesses that we know we can prevent, through positive interaction from Government.
Matt Hancock
Yes. My hon. Friend should know that, on this as on so many things, he and the Prime Minister are absolutely as one. Prevention is an incredibly important part of our plan. After all, prevention is better than cure.
Several hon. Members rose—
Matt Hancock
I want to make as much progress as I can, Madam Deputy Speaker, as I know that many people want to speak.
Another new addition to the policy agenda that has been brought in by the Prime Minister is that NHS infrastructure has gone right up the agenda and is a huge priority for this new Government. Modern buildings with cutting-edge facilities and equipment are essential to delivering the NHS that people deserve over the next decade, so we will deliver 40 new hospitals across the country, with £2.7 billion for the first six hospitals alone, £850 million for 20 hospital upgrades and £450 million for new scanners and the latest in AI technology. That is on top of the record capital budget this year.
Helen Hayes (Dulwich and West Norwood) (Lab)
King’s College Hospital in my constituency has the largest level of debt of any hospital trust in the country. That debt has come about because of the policies of the coalition Government and then the Conservative Government over the past 10 years, yet there is no investment for King’s in the Secretary of State’s list of hospitals receiving capital investment, and no proposal to write off the unsustainable level of debt. What message am I to take back to the hard-working, life-saving staff at King’s College Hospital who are currently struggling in impossible financial circumstances?
Matt Hancock
If the hon. Lady votes for this Bill, increased resources will be going into the NHS, including into King’s—mark my words!
Shaun Bailey (West Bromwich West) (Con)
One of the examples of this Government’s commitment to hospital infrastructure is the Midland Metropolitan Hospital that we are going to see in Sandwell, which many of my constituents will benefit from. Will my right hon. Friend assure me that, while we will obviously prioritise that, the existing infrastructure will still be prioritised as well? Will he meet me to discuss existing needs in west Sandwell in my constituency?
Matt Hancock
I am happy to meet my hon. Friend to discuss the needs of that hospital. It was started as a PFI, but I brought it on to the balance sheet to ensure that we can absolutely deliver it. This shows why people do not trust Mr PFI with the NHS.
Ben Everitt (Milton Keynes North) (Con)
I am sure that my right hon. Friend agrees with me on the need for hospital capacity to grow as our growing cities add to their populations. Will he commit to meeting me to discuss how we can bring forward and accelerate the infrastructure improvement plans for Milton Keynes Hospital?
Matt Hancock
Yes, I absolutely will. Milton Keynes hospital is extremely well run by fantastic staff. I did a night shift there a few months ago and—this is a really good example—the porters have redesigned their own system to make their job more efficient, and the management absolutely embraced it. It is an example of how good hospitals should be run. Perhaps on this point I can bring my speech to a conclusion—
Several hon. Members rose—
Mr Philip Hollobone (Kettering) (Con)
I thank the Secretary of State both for his commitment to fund the new £46 million urgent care hub at Kettering General Hospital and for including the hospital on the list for HIP2 funding from 2025 onwards. When will the hospitals on that shortlist get the seed funding to develop their plans?
Matt Hancock
The funding will be paid to the hospitals imminently, but it is definitely coming, so they can get on with planning for it.
Kate Green (Stretford and Urmston) (Lab)
A running theme throughout the Secretary of State’s speech has been an integrated approach to prevention and care. May I draw his attention to the need for dental care for cancer patients? There is no automatic route, as far as I can see, for oncologists to refer cancer patients for dental check-ups, and yet chemotherapy can have a deleterious effect on dental health, and patients also struggle to find NHS dentists due to a shortage of staff. Will the Secretary of State or one of his ministerial colleagues be willing to meet me to discuss that concern, which has been raised by my constituent Michelle Solak-Edwards, whose petition has been signed by many tens of thousands of others?
Matt Hancock
Of course. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), is responsible for prevention and primary care, which covers both cancer and dentistry, so I hope that she will be able pull those two parts of the NHS together.
This Bill is short and straightforward. It represents certainty for the NHS about a minimum funding level over the next four years and certainty for the 1.4 million colleagues who work in our health service, so that they have the confidence and capability to deliver the long-term plan, safe in the knowledge that we will support them every step of the way. Frontline staff have helped to shape this shared vision of the future of healthcare in this country—more preventive, more high-tech, with more empowered people—giving the NHS the tools it needs to rise to the challenge of increasing demands from a growing and ageing population. Doing nothing is not an option, and neither is simply pouring money in without a plan that embraces innovation and improvement. The long-term plan has precisely those principles at its heart. A vote for this Bill is a vote to give our NHS colleagues the certainty and assurance they need. This Government backs our NHS, and my party is the party of the NHS.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
This is not a serious funding Bill; it is an underfunding Bill. It is a political gimmick of a Bill. The Secretary of State hoped that the Bill would signal the Tories’ commitment to the NHS, but it actually reveals their lack of commitment to the NHS. I remind the Secretary of State that the last Labour Government, who I did indeed work for, did not need a piece of legislation to increase NHS funding by record levels—6% extra a year. We just got on and delivered record investment in the NHS in spending review after spending review. That record investment delivered the lowest waiting times, the highest satisfaction ratings, and 44,000 more doctors and 89,000 more nurses. He is unable to match that record.
This Bill essentially caps NHS funding—[Hon. Members: “No it doesn’t.”] It certainly does because, as the Secretary of State outlined, the amounts in the Bill are in cash terms, not real terms, which is what the previous Secretary of State presented to the House in summer 2018. The amounts in the Bill are in cash terms, and when my hon. Friend the Member for Nottingham South (Lilian Greenwood) asked the Secretary of State whether the NHS will get the real-terms increases that the previous Secretary of State outlined should inflation run at unforeseen levels, he could not give that commitment.
The Secretary of State could not give my hon. Friend the cast-iron commitment needed by the NHS chief executives on the ground because this Bill outlines only the cash figures. If inflation runs at a higher level than expected, the NHS will not get the extra money that the Secretary of State boasts about from the Dispatch Box unless we have that commitment. As the hon. Member for Glasgow North (Patrick Grady) said, the money resolution has been tightly drawn to restrict hon. Members from tabling amendments to give the NHS the levels of funding it needs. This Bill is a political stunt.
The Bill attempts to enshrine revenue spending in law, but the test will be whether the uplift outlined by the Secretary of State, albeit in cash terms, is sufficient to deliver on the promise made by the Prime Minister at the Dispatch Box two weeks ago:
“We will get those waiting lists down.”—[Official Report, 15 January 2020; Vol. 669, c. 1015.]
That means reversing the significant deterioration in care under this Government over a decade of decline.
This Bill fails the Prime Minister’s test, because the level of health expenditure that the Secretary of State is asking the House to put into law will not drive down waiting lists or drive up A&E performance to the levels our constituents deserve. The level of expenditure that the Secretary of State presents as an act of great munificence are not sufficient to enable the NHS to deliver the aspirations of its long-term plan. What he says is not what NHS Providers, the British Medical Association, the Health Foundation, the Institute for Fiscal Studies, a whole host of think-tanks and staff representatives are saying about the Bill.
Jonathan Ashworth
That is pretty dismal by the Secretary of State’s standards. [Interruption.] I am aware that his party won the general election, but it does not mean he is correct about NHS funding.
The Secretary of State is not prepared to put it in the Bill, but let us suppose he delivered on the real-terms increases outlined by the previous Secretary of State—around a 3.3% annual uplift for NHS England revenue. The problem is that NHS activity usually increases by 3.1% a year. We have an ageing population with a wide variety of complex conditions and a wide variety of co-morbidities, and we have seen years of austerity for which the Secretary of State was responsible as George Osborne’s right-hand man. We have seen health inequalities widen, needs increase and demands on the NHS rise, which is why health experts, including the IFS, the Health Foundation, NHS Providers, the BMA and a whole range of Royal Colleges, have said that health expenditure should rise across the board—not just in NHS England but in capital, education and public health—by 3.4% just to maintain current standards of care.
If we are to start driving down waiting lists, improving performance in A&E and driving down GP waiting times, as the Prime Minister promised on the steps of Downing Street, the NHS needs at least a 4% increase across the board. As the Health Foundation has said, investing in modernising the health service, as set out in the NHS long-term plan, requires around a 4.1% uplift a year. The Government are not giving the NHS 4.1% a year.
The Minister for Health (Edward Argar)
As ever, this has been an excellent and wide-ranging debate, with constructive speeches from both sides of the House. As my right hon. Friend the Secretary of State has said, the NHS is the people’s priority and it is our priority. Today, we take another important step towards delivering on our manifesto commitment: our pledge to the people to enshrine in law the record funding for our NHS.
The NHS has a long-term plan to build a sustainable health and social care system that can rise to the challenges of the future. The NHS has told us how much funding it needs to deliver that plan and the Government are providing it. By 2023-24, the NHS will have an additional £33.9 billion to spend each year. I welcome the Opposition’s willingness to support the Bill, as indeed they should; it provides an iron-clad guarantee to deliver the NHS funding. In doing so, we are giving the NHS the certainty it needs to invest now for the long term.
Mr Steve Baker (Wycombe) (Con)
As the Opposition Front Benchers are engaged in a conversation and not listening to my hon. Friend, will he repeat the point he made about the Government giving NHS England the money that it has asked for?
Edward Argar
I have already stated that at the Dispatch Box and my hon. Friend makes the point even more forcefully.
Let me turn to the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth). Like the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), he is a good man and genuinely believes passionately in our NHS, and he campaigned passionately for his party. I have to say, though, that I was a little surprised by his comments suggesting that the Bill caps spending. Had he read the Bill, he would have found that, only four lines in, it states clearly:
“an amount that is at least the amount specified”.
That is a floor, not a cap.
More broadly, I suggest to the Opposition that they may want to be a little cautious when talking about the financial situation that we inherited. Labour’s legacy, as so wonderfully encapsulated in a letter by the former Chief Secretary to the Treasury, the right hon. Member for Birmingham, Hodge Hill (Liam Byrne), is that “there is no money”. It is this Government who have invested in supporting and rebuilding our nation’s finances to give us the strong economy that allows us to invest in our NHS.
Jonathan Ashworth
I am grateful to the Minister for his comments about me. He is a fellow Leicestershire MP and I know that he is passionate about the NHS as well.
If the Bill is not a capped-expenditure Bill, why are the numbers in it in cash terms and not the real-terms percentage increases that the previous Secretary of State, the right hon. Member for South West Surrey (Jeremy Hunt), set out to the House in June 2018?
Edward Argar
Because the cash set out in the Bill is the money that the NHS is going to be getting as a floor.
The shadow Minister rightly raised the issue of mental health. My right hon. Friend the Secretary of State was rightly clear that spending on mental health provision will increase the fastest under the proposals in the Bill, with spending on children’s mental health increasing the fastest of all. I am sure the Opposition will welcome that.
My right hon. Friend the Member for South West Surrey (Jeremy Hunt) rightly highlighted the quantum of spending and how that compares to other countries around Europe and, indeed, in the OECD. I pay tribute to him, because a lot of what we are talking about today is based on the foundations that he built when he did such a fantastic job as Secretary of State.
The hon. Member for Central Ayrshire (Dr Whitford) and my hon. Friend the Member for West Aberdeenshire and Kincardine (Andrew Bowie) rightly alluded to the Bill’s impact on Barnett consequentials and spending in Scotland. As the hon. Lady will know, the Barnett consequentials will apply. My hon. Friend highlighted the fact that not only the NHS in England but the NHS in Scotland faces challenges that we must all step up to meet.
My hon. Friend the Member for Newton Abbot (Anne Marie Morris) highlighted the need for us to focus not just on inputs but on outcomes and what we achieve with the money that we invest. That is exactly what the Secretary of State is determined to do.
The hon. Member for Nottingham South (Lilian Greenwood), a fellow east midlands Member, highlighted the need for capital investment in her local hospitals in Nottingham. I am happy to meet her to discuss that further, if that would be helpful to her.
Let me turn to maiden speeches. My hon. Friend the Member for Darlington (Peter Gibson) made an excellent maiden speech. As Members have said, his predecessor Jenny Chapman was respected and well liked in the House. I suspect that, given his speech, he will achieve exactly the same distinction. He spoke forcefully and powerfully on behalf of his constituents. I am sure that they will find him a doughty local campaigner in their interest.
My hon. Friend the Member for Ashfield (Lee Anderson) paid tribute to his predecessor, Gloria De Piero, who was my shadow when I was a Justice Minister. He was right to pay tribute to her, because she was a fantastic colleague to have in this House. None the less, he achieved a fantastic result. As a fellow east midlands MP, I know his constituency well. It is a fantastic place and his constituents are very lucky to be represented by him. He is a local man standing up for his community. He also spoke movingly of his journey—if I may put it this way—from pit to Parliament, and the power of social mobility, of aspiration and of opportunity. He reminded me of a former colleague of ours and a good friend of mine, Sir Patrick McLoughlin, who made the same journey. He ended up in the Cabinet, so I will be watching my hon. Friend’s inevitable ascent carefully.
The hon. Member for Feltham and Heston (Seema Malhotra) touched on, among other things, Heston health centre. Again, as ever—as in my previous role—I am happy to meet her to discuss that. The hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey), in an eloquent but forceful maiden speech, clearly put this House on notice that he will always speak up for his principles and his beliefs, and, while we may on occasion disagree on policy, I doubt we will disagree on his passion and determination to champion his constituents’ interests.
My hon. Friend the Member for Dover (Mrs Elphicke) also focused on achieving outcomes. She touched on the tragic death of Tallulah-Rai Edwards. I extend my condolences to the family, but may I also say that my hon. Friend the Parliamentary Under-Secretary of State for patient safety will be happy to meet her to discuss that in more detail.
It is always a pleasure to meet the hon. Member for Easington (Grahame Morris) and to hear from him. We have met previously, and he and the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), are due to meet again to discuss this matter in a few weeks’ time when we will pick it up further.
Let me turn now to my hon. Friend the Member for Birmingham, Northfield (Gary Sambrook). May I pass on my congratulations to his sister on the birth of Freddie and pay tribute to all staff, as he did, working in our amazing NHS for the work that they do. Many hon. Members paid tribute to them, including the hon. Member for Rhondda (Chris Bryant), and my hon. Friend the Member for Banbury (Victoria Prentis)—I have no doubt that I will be hearing from her about the Horton on many occasions in the future. My hon. Friends the Members for North Dorset (Simon Hoare) and for South Dorset (Richard Drax) made powerful pleas for investment in their community hospitals and in their local health infrastructure. I am a regular visitor to the constituency of my hon. Friend the Member for North Dorset, so I look forward to visiting both colleagues in due course.
As well as talking about Crawley Hospital, my hon. Friend the Member for Crawley (Henry Smith) highlighted the need for Gatwick airport to be included in the conversations on the coronavirus, and I know that my right hon. Friend the Secretary of State will have heard what he said, and is already factoring that in.
Before concluding, I will touch very briefly on two other contributions: my hon. Friends the Members for Stoke-on-Trent Central (Jo Gideon) and for Stoke-on-Trent North (Jonathan Gullis)—and indeed my hon. Friend the Member for Stoke-on-Trent South (Jack Brereton), who was not in his place. They have all highlighted the issue of the private finance initiative. I am happy to meet them to discuss it further.
Let me turn now to my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) and the hon. Member for Mitcham and Morden (Siobhain McDonagh). I have to say that my hon. Friend made a very strong case for the benefits that this investment will bring for all those who are served by his local trust. I encourage the hon. Lady to engage with this process and engage with the benefits that this investment will bring.
Edward Argar
I am afraid that, with one minute to go, I will not give way.
The nation’s health and social care is the people’s priority and it is also our priority. Key to delivering on our long-term plan, and the NHS’s long-term plan, is giving the NHS the investment that it needs. This Bill does exactly that. We are delivering on the people’s priorities and on our pledges to the NHS, and I commend the Bill to the House.
Question put and agreed to.
Bill accordingly read a Second time.
Tuesday 4th February 2020
(4 years, 2 months ago)
Commons ChamberRead Hansard Text Amendment Paper: Legislative Grand Committee (England) Amendments as at 4 February 2020 - (4 Feb 2020)
17:32 - The Committee having divided: - Ayes: 163 / Noes: 300 - Question accordingly negatived.
18:03 - The Committee having divided: - Ayes: 161 / Noes: 298 - Question accordingly negatived.
18:23 - The Committee divided: - Ayes: 162 / Noes: 298 - Question accordingly negatived.
This text is a record of ministerial contributions to a debate held as part of the NHS Funding Act 2020 passage through Parliament.
In 1993, the House of Lords Pepper vs. Hart decision provided that statements made by Government Ministers may be taken as illustrative of legislative intent as to the interpretation of law.
This extract highlights statements made by Government Ministers along with contextual remarks by other members. The full debate can be read here
This information is provided by Parallel Parliament and does not comprise part of the offical record
Alex Cunningham
I am very grateful, Madam Deputy Speaker.
Amendment 2 concerns spending on mental health services and the Secretary of State’s plans to achieve parity of esteem. Mental illness is often not viewed as a risk to human life, but it is exactly that. In 2018, according to the Samaritans, 6,507 deaths in the United Kingdom were registered as suicides—an increase of 10.9% on the previous year. That means that nearly 7,000 people did not believe that there was help, or another way out of what they were going through.
It can be hard for adults to talk about the feelings that come from being mentally unwell. The words are in their vocabulary, and it may be simple enough to string them together into a sentence, but it is incredibly difficult to say them out loud. I can only imagine how hard it must be for children to express how they are feeling when something is not right. Perhaps they do say the words that are in their heads, but they are not taken seriously. It is a scandal that there are suicidal children as young as 12 who are having to wait more than two weeks for a mental health bed. By not viewing mental illness as life-threatening, we are letting generations down.
There is much debate about what causes mental illness and what is the best form of treatment, but it can take several visits to a GP for people to be taken seriously about not being OK—although many GPs, of course, respond immediately. When parents are fighting for their unwell children to be taken seriously and receive the urgent care and treatment they need, it is horrifying for that to be delayed.
At this stage I should pay tribute to my former colleague Paul Williams, who was the Member of Parliament for Stockton South. He is a GP, and as a member of the Health Committee he spoke extensively about health matters, but locally he took on the child and adolescent mental health services. He knew, as I did because we shared the same area, that it was taking well over two years for young people to be seen by CAMHS. As a direct result of his work, that ended, up to a point, because some children who were due to be seen quickly were actually seen when they should have been. However, those long waits still exist in our area. As we heard earlier from the right hon. Member for South West Surrey (Jeremy Hunt), the former Health Secretary, sometimes children are just not taken seriously.
It is right for the Secretary of State to answer to the House on exactly what the Department is doing, because this is a matter of life and death. Not only the House but the country needs assurance and answers. The state of mental health services will only get worse unless we take action to deliver what is required. The additional money is more than welcome, but I see the amendment as the first, necessary step to provide the funds that are so desperately needed. Equally important is the ability to monitor what those funds are being spent on, and how.
There are many other services on which people depend heavily, including some that we may take for granted, such as smoking cessation services. There is widespread concern about existing funding for services to help people stop smoking. Nearly a third of local authorities no longer provide specialist “stop smoking” services. Stopping smoking is not just a matter of nicotine patches or vaping; people need behavioural support as well, particularly pregnant women, children, and people who are already unwell. One ward in my constituency has some of the highest incidences of smoking in families—whole families smoking—but we also have some of the highest incidences of smoking during pregnancy, and that is not good for the unborn child.
We cannot afford to lose the progress that we have made. We have made tremendous progress over the years, but we need local services that are effective and properly funded. The Government also need to return to funding the multi-media approach to smoking cessation services. I was particularly pleased to learn last week that research has shown that the ban on smoking in cars when a child is present has produced a 75% drop in children being exposed to cigarette smoke in a car. I led on that issue during my first few years as an MP, through private Members’ Bills and a ten-minute rule Bill. The Bills were unsuccessful, but I was delighted when the Government adopted my clause a few years later. We still need to be ambitious and bold about helping people to quit smoking, but services need the resources. I hope the Minister will commit to ensuring that such services are provided, whether for mental health or for smoking cessation, and that they are fully funded so that we can continue to make real progress in that area.
Finally, I shall turn to the matter of capital. The Minister has already heard me talk about the needs in my own constituency. In one ward—the same one I referred to earlier: the Town Centre ward in Stockton—men live 14 years less than those in the Prime Minister’s constituency. His constituency is getting a new hospital, but there are no plans yet for us. However, I have good news for the Minister, because the plan for our hospital is still sitting there. I met the chief executive of North Tees and Hartlepool NHS Foundation Trust just two weeks ago, and she told me that they were ready to dust off the plans again and see how we could provide a hospital. At the time we asked for £100 million from the Government as a guarantor in order to make the project work. The numbers do work, and the health inequalities need to be addressed.
We need to be able to attract the best doctors and clinicians that we can to address the problems in our society. The heart problems are higher on average than anywhere else in the country. We have smoking problems, as I have mentioned, with their related lung and respiratory problems. We also have the legacy of our heavy industry on Teesside, where men who have now retired are in extremely ill health but sometimes cannot get the support they need because we do not have the experts locally to provide it.
In my final sentences, I appeal to the Minister to meet me and the trust members so that we can sit down and talk about this project.
Alex Cunningham
I am glad that he is nodding his head. Ten years ago, the Tory-Lib Dem Government cancelled the project, despite the fact that it was a priority for the country and for the national health service, so I hope that we can now have a meeting and actually start to motor on this. I am pleased to see the Minister smiling, and I hope that he can leave me smiling as well.
The Chairman of Ways and Means (Dame Eleanor Laing)
The hon. Gentleman is absolutely right in regard to the procedure. If we finish this part of the procedure before 5.29 pm, there will be a very short time for the next part of the procedure. If this part of the consideration of the Bill goes to 5.29 pm, there will indeed be no time for the Report and consideration stage. That is correct, as is normal in any Bill, but I am grateful to him for pointing it out so clearly.
Edward Argar
In the 15 or so minutes remaining to me, I will endeavour to address all the points that have been raised. First, I thank Members on both sides of the House for their contributions and for the amendments that have been tabled. I particularly thank the shadow Minister for his typically reasonable tone in making his case forcefully. This Committee debate has been a wide-ranging and important one.
I will turn in detail to the amendments shortly, but, in the interests of time, I will swiftly address the requests for meetings or visits. The hon. Member for Stockton North (Alex Cunningham) was right when he said that he saw me nodding. I will be very happy to meet him, my hon. Friend the Member for Stockton South (Matt Vickers) and the chief executive of his hospital trust to discuss the issues that he raised. I will also be very happy to meet the hon. Member for Harrow West (Gareth Thomas) separately to discuss the issues that he raised.
Edward Argar
I will give way very briefly, because the hon. Gentleman is eating into his own time.
Pete Wishart
The Minister is in a very accommodating mood. Does he accept that this Bill has funding implications and consequences for health spending in Scotland?
Edward Argar
As has been very clear throughout the progression of this Bill so far, there are Barnett consequentials, which will be dealt with in the usual and appropriate manner.
I will turn to the detail of the amendments in a moment, but before I do, let me say that my hon. Friend the Member for Telford (Lucy Allan) addressed the debate in Westminster Hall just before the general election. In that, I said that if her constituents wanted a strong voice in this place, they should vote for her. I am very pleased that they did exactly that. Her speech shows exactly why.
This legislation is a simple Bill of two clauses. The substantive clause—clause 1—puts a double-lock duty on the Secretary of State and Her Majesty’s Treasury to ensure that NHS England will receive, as a minimum, £33.9 billion extra a year by 2024, enshrining in law the NHS England revenue budget rise in line with the Government’s manifesto commitment. The Bill has deliberately been drawn narrowly to focus on that core commitment.
Theo Clarke (Stafford) (Con)
This Bill is about funding, but buildings and services are key to delivering on our national health service priorities, so may I highlight the importance of the A&E at the County Hospital in Stafford and ensuring that we are supporting NHS services in my constituency?
Edward Argar
My hon. Friend is a sound and vocal champion for her constituents in Stafford. I am sure that she will continue to champion their cause, and I am happy to meet her to discuss the specific issue she raised.
I turn to amendment 3, in respect of capital-to-revenue transfers. Clause 1(2) ensures that the funding specified in the Bill can only be used for NHSE revenue spending, meaning that day-to-day spending for the NHS is protected. As we have highlighted in the House previously, the Government have made a range of capital commitments to the NHS, including the commitment to 40 new hospitals. Nevertheless, going to the point in the amendment itself, we have been clear that the transfers from capital revenue should have only been seen as short-term measures that were rightly being phased out, and we are doing so. My right hon. Friend the Member for South West Surrey (Jeremy Hunt), the former Secretary of State, did, however, set out why a degree of flexibility is required, and we would not believe that a blanket ban set in legislation was the right approach.
Edward Argar
I will not, if the hon. Gentleman will forgive me, as I only have 10 minutes or so left.
There are sometimes very good and logical reasons why adjustments between capital and revenue are needed. As the former Secretary of State highlighted, in some cases, for perfectly good reasons a capital pot may not be spent fully within a year and there is an opportunity to achieve patient good from transferring it. While I take his point and believe it is right that we should continue to move away from such transfers, I would not wish to see that rigidly set in legislation.
Amendments 2 and 1, and new clauses 1, 2, 3 and 9, relate to mental health services both for children and adults, and accountability to Parliament and reporting mechanisms. We have rightly seen considerable interest in mental health in this debate, so I will seek to address both those points together. I begin by paying tribute to Paul Farmer of Mind, Sir Simon Wessely, Professor Louis Appleby, the Mental Health Foundation, Rethink Mental Illness, YoungMinds, the Royal College of Psychiatrists, and a host of other individuals and organisations up and down the country, for their fantastic work in making mental health such a feature in our debates and in the public consciousness. It is absolutely right that they have done so.
I pay tribute to the Under-Secretary of State, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), and her predecessor, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who brought to the role of mental health Minister passion, dedication and a determination to make a difference. I should also reference some former Members of this House: Norman Lamb, who did so much in this area; the former Prime Minister, David Cameron; and of course my right hon. Friends the Members for South West Surrey and for Maidenhead (Mrs May), who ensured that it was front and centre of this Government’s commitment.
I want to be totally clear that the Government are fully committed to transforming mental health services. That is why we enshrined in law our commitment to achieving parity of esteem for mental health in the Health and Social Care Act 2012. As my right hon. Friend the Member for South West Surrey said, that is driving real change on the ground. We have also committed to reforming the Mental Health Act 1983 to provide modernised legislation. I would also highlight that at £12.5 billion in 2018-19, spending on mental health services is at its highest ever level.
We have made huge strides in moving towards parity, but there is still so much more to do. We are ensuring, through the NHS long-term plan, that spending on mental health services will increase by an additional £2.3 billion by 2023-24. This historic level of investment in mental health is ensuring that we can drive forward one of the most ambitious reform programmes in Europe. It will ensure that hundreds of thousands of additional people get access to the services they need in the lifetime of the plan. I flag that up because we can and will always strive to do more, and it is right that we are always pressed by this House to do so. While proposals for a ring fence in mental health spending are understandable, the approach that this Government have already set out, with long-term commitments to funding, is already driving the results we wish to see.
I now turn to new clause 9, tabled by my hon. Friend the Member for Newton Abbot (Anne Marie Morris). If I may, I will also address new clause 2 in this context because there is a degree of overlap. I welcome my hon. Friend’s new clause. Although I hope that, as she indicated, she will not press it to a vote—and I heard what the hon. Member for Twickenham (Munira Wilson) said in respect of hers—the sentiment behind it is a good one, particularly the focus on outcomes and outputs rather than simply inputs and the amount of money going in, and on adopting a holistic approach. I know that my hon. Friend the Member for Newton Abbot recently met the Secretary of State to discuss the matter, and I am happy to meet both her and the hon. Member for Twickenham. While we do not believe it is the right approach to set additional reporting mechanisms in legislation over and above the different reports that NHS England and the Secretary of State already make to Parliament, which offer opportunities for debate, we are happy to consider whether, within the existing reporting mechanisms, there is a way to better convey to the House and the public more widely the progress we are making against those targets.
The NHS long-term plan represents the largest expansion of mental health services in a generation, renewing our commitment to increase investment faster than the overall NHS budget in each of the next five years. Not only will spending on mental health services increase faster than the overall NHS budget as a proportion, but spending on CAMHS will increase at an even faster rate. The hon. Member for Twickenham was right to highlight the importance of CAMHS. In our surgeries, we have all had constituents come to see us who are deeply worried and concerned about the mental health and welfare of their children, be that in relation to eating disorders, which I focused on when I came to this place, or a range of other factors. We are committed to delivering the NHS long-term plan to transform children and young people’s mental health services, with an additional 345,000 children and young people being able to access those services.
While we are deeply sympathetic to the spirit behind the amendments on mental health spending, we do not believe that putting a ring fence into the Bill is the appropriate way forward, given the work already being done, the money already being spent and the outcomes already being delivered. We believe that the reporting requirements are already extensive and varied. They already give the public and Parliament the opportunity to scrutinise the work of the Department and NHS England. We are happy to look at ways in which those reports might be more accessible and include different metrics, but we believe it would be wrong to legislate on them at this point.
As I said on Second Reading, this is a simple Bill. It has two clauses, of which one is substantive. It has a single, simple aim: to enshrine the funding settlement behind the NHS long-term plan in law. It delivers the funding that the NHS said it needed and wanted, and it delivers on this Government’s pledge to do so within three months of the election. In the light of that, while the amendments are clearly well intentioned and we appreciate the spirit behind them, they are unnecessary additions to the Bill, and I urge their proposers not to press them to a vote. I appreciate that Members have indicated their intention to press some amendments to a vote, I urge them, in the short period remaining before Committee ends, to reflect a little longer on whether they might reconsider and not move their amendments to a vote.
Patrick Grady
On a point of order, Dame Eleanor. I think that we should mark this moment. This is the busiest that the English Parliament has been since 1707. I have never seen so many people so keen to take part.
I am interested in the numbers that have just been read out, Madam Deputy Speaker, because 163 for the Ayes seems very low to me. Just by means of a headcount, I counted a significant number more than that. In fact, according to my calculations, at least 46 Members from Scotland, Wales and Northern Ireland were in the Lobby just now. Can you tell me whether the number that was read out in the House accurately records the number of Members of Parliament who wished to express their view on the amendment?
The Chairman
I am afraid that the right hon. Gentleman does not quite explain the situation as it really is. You see, this Parliament, as the Parliament of the United Kingdom, passed certain rules some time ago, and it is not correct to say that Members from Scottish constituencies are locked out; far from it. Members from Scottish constituencies, and constituencies in every part of the United Kingdom, have not been locked out. They have been allowed to participate in the debate, but not to vote in it. Members from Northern Ireland constituencies and from Welsh constituencies are similarly categorised for the purpose of these particular Divisions.
The Chancellor of the Duchy of Lancaster (Michael Gove)
Further to that point of order, Dame Eleanor. Is it not the case that health is a devolved matter, and that the NHS in Scotland is the responsibility of the Scottish Parliament? Is it not the case that, therefore, Members of this House have no votes on, or say in, what happens in the NHS in Scotland, and is it not appropriate to point out to SNP Members that while they stage these stunts here, the Royal Hospital for Sick Children in Edinburgh, for which they are responsible, remains closed, and cases of poisoning in hospitals in Glasgow for which they are responsible remain undealt with? Until the Scottish Government make sure that the health of the people of Scotland is looked after, the people of Scotland will regard this as a transparent stunt on the part of people who, instead of representing their constituents, seek to manufacture grievance.
The Chairman
I fully appreciate the point—[Interruption.] Order. This will not degenerate into a shouting match.
The right hon. Gentleman has expressed his view with his usual rhetorical flourish. My only comment must be that this is a very narrow Bill, specifically making provision for the funding of the health service in England. I have to go with what it says on the Bill, and it is therefore correct for it to be administered in this way.
Madam Deputy Speaker
The hon. Gentleman’s analysis is not wrong. The knife has fallen. The House voted some days ago to provide three hours, or four hours in total, for consideration of this Bill, and it is indeed the case that because those four hours have passed, there is no time for debate on consideration and Report—that is absolutely correct. There is also no time for debate on Third Reading.
As to whether the Government did not provide sufficient time, or Members of this House took up all the time in the early part of the proceedings, that is not a matter for me to judge; I have merely facilitated it. Members might have decided not to speak for very long at the beginning. If so, the hon. Gentleman and his colleagues would have had the opportunity to discuss the matters that they had tabled. I thank him for his further points.
Does the Minister intend to move a consent motion in the Legislative Grand Committee?
Edward Argar
indicated assent.
The House forthwith resolved itself into the Legislative Grand Committee (England) (Standing Order No. 83M(3)).
[Dame Eleanor Laing in the Chair]