NHS Integrated Care System Boundaries

Edward Argar Excerpts

Tuesday 29th June 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

I congratulate my hon. Friend the Member for Harwich and North Essex (Sir Bernard Jenkin) on securing this timely debate about potential changes to ICS boundaries—and indeed on elevating me to the Privy Council, for which I am grateful. He and I have known each other for a long time and I always listen carefully to what he says. When there was the prospect of extra time, our friendship might have been in doubt had I been in here and unable to see the final result, but we got the result we all wanted just in time, so it is a pleasure to be here today.

The subject is important, not only for my hon. Friend, who works tirelessly for his constituents, but for all hon. Members who have spoken. The provision of healthcare goes to the heart of what many of our constituents care passionately about.

In his remarks, my hon. Friend expressed his concerns about the future of Suffolk and North East Essex ICS as one of the areas included in the NHS England ICS boundary review. I am grateful that he has called the debate, not only to allow fellow parliamentarians to express their views before any decision might be made on the Floor of the House, but to let me listen once again to them. I am equally grateful to my right hon. Friend the Member for Maidenhead (Mrs May). She and I have known each other a very long time and she knows that I have huge respect for her opinions. When she speaks, I always listen carefully.

As has been said, in the recent White Paper, we set out proposals to place integrated care systems in statute. We are working with NHS England and the Local Government Association to deliver and develop those proposals. At the outset, it is important that I highlight a key point. Members alluded in their remarks to the feeling that something here is predetermined. If there is such a feeling, that is a challenge for us to overcome because I want to reassure hon. Members that nothing is predetermined in any of the specific situations that they have outlined.

As has been set out, ICSs aim to strengthen partnerships and joined-up working between the NHS and local authorities. Local authorities therefore have a key role in ICSs. We know that coterminous boundaries can support more joined-up working between the NHS and local government, but I take on board entirely from my time as a local councillor—indeed, as a cabinet member for health and adult social care—the point that my right hon. Friend the Member for Maidenhead made that sometimes natural geographies of place can mean a lot more to our constituents than administrative boundaries to which we as politicians might pay a lot of attention.

For the reasons I have given, earlier this year the former Secretary of State, my right hon. Friend the Member for West Suffolk (Matt Hancock), asked NHS England to conduct a boundary review to understand what the options—I emphasise options—were to achieve alignment in the small number of areas where coterminosity was not already in place. He set out to do that in two stages: NHS England and its regional teams have led on the review at a local level, engaging with local NHS and local authority stakeholders to determine options for alignment, local views and concerns, and to put forward a fair reflection of what they had heard, while in parallel I, as a Minister of the Crown, have held multiple meetings with parliamentary colleagues. I think I have met well over a dozen colleagues in person or virtually—in this day and age—and held almost 10 different meetings.

I thank NHS England for all its engagement and work on the review. As I say, over the past six months its regional teams have worked closely with local NHS and local government stakeholders to consider, with an open mind, the options available for the areas identified in the review.

As right hon. and hon. Members have made clear, it is important to recognise where things are working well irrespective of coterminosity and serving Members’ constituents well. As I say, the review is without prejudgment and I would not wish to pre-empt what may be either recommended or even just set out as options. In that context, keeping the current arrangements would of course be an option to consider. I reassure Members that the Secretary of State and I do have at the forefront of our minds the need primarily to ensure the best health outcomes for local people when any decision is taken. I hope that my hon. Friend the Member for Harwich and North Essex will recognise the sincerity with which I say that.

Before I conclude, let me turn to a couple of specific points that my hon. Friend mentioned. I wish to clarify that were any changes made to ICS boundaries as a result of the review, they would not impact on the patient’s right to choose or use services outside of their ICS or current patient pathway flows.

On funding, I wish to try to reassure my hon. Friend a little more than perhaps he was reassured in the meeting to which he alluded. Once ICSs are placed on a statutory footing, the allocation of resources to each integrated care board will be determined by NHS England based on the long-standing principles of ensuring equal opportunity of access for equal need and reflecting the considerations that currently inform how moneys flow to areas when following the patient.

[Sir Bernard Jenkin]

Will my hon. Friend allow me to intervene on one point?

[Edward Argar]

Briefly, because I want to give my hon. Friend the reassurance that he seeks before the time runs out.

[Sir Bernard Jenkin]

What my hon. Friend has said does not address how Suffolk would be funded to commission services for Essex patients at an Essex hospital, and it does not address what will happen to the distribution of deficits, which is uneven across the existing ICSs.

[Edward Argar]

I would try to address that point briefly, but I think my hon. Friend would rather have the reassurance that I can give him. Perhaps I can pick up that point separately with him, because I do not want to run out of time.

Finally, and most importantly, I reassure my hon. Friend and other Members that no decisions have yet been made regarding the outcome of the ICS boundary review. As he would expect, the newly appointed Secretary of State will want to consider carefully the background to this issue, the options before him and, indeed, the views of right hon. and hon. Members before any decision is made. I have discussed this matter with the new Secretary of State and wish to extend his clear commitment to meet my hon. Friend, my right hon. Friend the Member for Maidenhead and other Members before he makes any decision and decides how to proceed in this matter.

My hon. Friend knows me well, and my preference is generally for evolution, not revolution. I hope that, him knowing me well and in the light of what I have said today, he will recognise the sincerity of what I say. I also hope it is helpful that I have put on record, once again, that no decisions have been made and that Members will be consulted and have the opportunity to speak to the Secretary of State. I hope that commitment reassures my hon. Friend, at least in the short term, that nothing will happen without him and other Members having their say clearly on the record.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I normally thank the Minister politely at this point in the day, but I really do thank the Minister for what he has just said on this particular occasion.

Indemnity for the Independent Review into Issues Raised at West Suffolk NHS Foundation Trust

Edward Argar Excerpts

Tuesday 22nd June 2021 Written Statements

[The Minister for Health (Edward Argar)]

It is normal practice, when a Government Department proposes to undertake a contingent liability in excess of £300,000 for which there is no specific statutory authority, for the Minister concerned to present a departmental minute to Parliament giving particulars of the liability created and explaining the circumstances; and to refrain from incurring the liability until 14 parliamentary sitting days after the issue of the minute, except in cases of special urgency.

I have today laid a departmental minute proposing the provision by NHS England and NHS Improvement of an indemnity that is necessary in respect of an NHS England and Improvement non-statutory, independent review of whistleblowing at West Suffolk NHS Foundation Trust.

This review follows widely reported events arising from an anonymous letter that was sent in October 2018 to the relative of a patient who had died at the trust. The purpose of the review is:

to consider the appropriateness and impact of the actions taken in response to the issues raised by/connected with the October letter by the trust and other relevant bodies; and

to produce advisory recommendations and learnings.

The indemnity will cover any sums, including any legal or other associated costs, that members of the review team are liable to pay in relation to legal action brought against them by a third party in respect of liabilities arising from any act done, or omission made, honestly and in good faith, when carrying out activities for the purposes of the review. The indemnity will apply to any work carried out from the commencement of the review to its completion in 2021, in accordance with the review terms of reference. The indemnity will cover the contingent liability of any legal action in the run-up to and following the publication of the review report, and for two years after that date. If the liability is called, provision for any payment will be sought through the normal supply procedure.

The Treasury has approved the proposal in principle. If, during the period of 14 parliamentary sitting days beginning on the date on which this minute was laid before Parliament, a member signifies an objection by giving notice of a parliamentary question or by otherwise raising the matter in Parliament, final approval to proceed with incurring the liability will be withheld pending an examination of the objection.

A copy of the attachments can be viewed online at: Written statements - Written questions, answers and statements - UK Parliament

[HCWS110]

Coronavirus

Edward Argar Excerpts

Wednesday 16th June 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

At the outset, I associate myself with the shadow Minister’s remarks in respect of our late colleague, Jo Cox. As we stand at this Dispatch Box, we can see the coat of arms above the Opposition Benches. I pay tribute to her and to all the work that she did while she was in this place, and before.

I would much rather I were not standing here today urging and encouraging colleagues to vote for this motion. I know that colleagues would wish that it were not necessary, but I regret to say that it is. We have made huge progress—progress that has been made possible by our phenomenal vaccine roll-out programme. The tribute for that goes to the scientists who developed the vaccine, those who procured it, the NHS, all the volunteers, the charities, the military, The Sun’s jabs army and everyone who has played their part in helping to deliver this programme. That progress has also been made possible by the incredible efforts of the British people, and by the dedication of everyone who works in our health and care system. I know the shadow Minister will join me in expressing our joint gratitude to them all.

As the Prime Minister set out on Monday, this vaccine remains our route out of the pandemic. With every day that goes by, we are better protected by our vaccines, but the delta variant has made the race between virus and vaccine much tighter. Cases continue to grow rapidly each week in the worst-affected areas. The number of people being admitted to hospital in England has begun to rise, and the number of people in ICUs is also rising, but the vaccine remains our way out.

Data published this week shows that two doses of the jab are just as effective against hospital admission with the delta variant, compared with the alpha variant, and indeed they may even be more effective against the delta variant. That underlines the importance of that second jab and the need for more of us to have the chance to get its life-saving protection.

My right hon. Friend the Member for North Somerset (Dr Fox) put it far more effectively than I dare say I will be able to do. He was absolutely right to highlight the crucial importance, over the next few weeks, of getting those second jabs—particularly the AstraZeneca vaccine—into people’s arms. He is right to highlight that after one jab, the Pfizer vaccine is highly effective, but we need two jabs of the AstraZeneca vaccine to provide that level of protection. It is important, in that context, to remember that the AZ vaccine is the workhorse of our vaccination programme. More than 30 million people have now received their second jab, and in one month’s time that number could stand as high as 40 million. My right hon. Friend the Secretary of State highlighted in his remarks an important factor in getting those second doses into people’s arms. There are still 1.2 million over-50s who have had their first dose—they are not declining the vaccine; they have had the first dose—but who need the second dose to provide that high level of protection. Similarly, there are 4.4 million over-40s who need their second dose. With the delta variant now making up nine in 10 of the cases across the UK, it is vital we bridge the gap and get many more people that life-saving second jab.

This extra time will allow us to get more needles into more arms, getting us the protection that we need and enabling us to see restrictions fall away on 19 July. In that vein, I would remind colleagues of the quote from the Prime Minister on Monday, when he was very clear:

“As things stand, and on the evidence that I can see right now, I am confident that we will not need more than four weeks and that we won’t need to go beyond 19 July.”

[Sarah Owen]

The Minister just said that the Prime Minister has given assurances about another four weeks, but we have had this time and time again. Why should the British people believe the Prime Minister now?

[Edward Argar]

The short answer is that the British people do believe the Prime Minister now.

We face a difficult choice, and my hon. Friend the Member for Bosworth (Dr Evans) set it out extremely clearly. It reflects the underlying debate about risk. I am clear that we must learn to live with this disease, without the sort of restrictions we have seen. We cannot eradicate it. I have to say that, rather than relying on the views of the hon. Member for Leeds East (Richard Burgon), I am inclined to rely on the views of my right hon. Friend the Member for North Somerset, who made that point very clear. Those who advocate zero covid must realise that that is impractical and unachievable, and I consistently do not subscribe to the logic of those who argue for that course.

I am sure the House will agree that, to get to the point where we can learn to live with this disease, an extra few weeks are a price worth paying. I therefore urge the House to support these regulations today. No one can fail to be sympathetic to those who will be affected by this delay, including those couples who want to start their married lives together but have had to change or delay their plans. This weighs on me greatly, as it will on all hon. Members, and in this case I was pleased that we could ease the restrictions on weddings. Equally, I am mindful of those whose livelihoods will be affected by any delay in our road map. I urge the House to support this motion. It provides a short-term delay that significantly strengthens our position for the longer term.

My right hon. Friend the Member for Forest of Dean (Mr Harper) raised a couple of specific points which I will try to answer here; they relate to each other. He mentioned paragraph 7.7 of the explanatory memorandum and his concern that the first review date was on 19 July. I can clarify that the first review date is due by Monday 19 July and will be in advance of that point. That is a legal end point. I would anticipate an announcement coming probably a week before that on the decision and the data. I hope that gives him some reassurance about people having notice of what is coming.

In closing, I wish to express my sincere thanks to all those who have contributed to today’s debate. I am sorry that so few on the Opposition Benches chose to take part, but I pay tribute to those who did and to those on this side of the House for the sincerity, the strength of feeling and the integrity that they have shown. I hope the House recognises that I have a deep-seated respect for all the views I have heard this afternoon. Hon. Members all want the same thing, which is to save lives and to see us exit these restrictions and return to normality as soon as possible. Difficult as it may be, I urge hon. Members across the House to vote for these measures to give ourselves that short extra time to vaccinate more people—crucially, with that second dose—and take us forward to the stronger, more confident future that we all seek, which I know is just around the corner and which I am confident the Prime Minister will take us to. I commend the motion to the House.

Question put.

New Airedale Hospital

Edward Argar Excerpts

Tuesday 15th June 2021 Westminster Hall

[The Minister for Health (Edward Argar)]

I have known you a very long time, Sir Edward, so it is always a pleasure to serve under your chairmanship in this place.

I congratulate my hon. Friend the Member for Keighley (Robbie Moore) on securing this debate. I know that since his election to this House, he has worked tirelessly for his constituency, not just on healthcare matters but in representing all of his constituents’ needs, particularly, in the context of my role within Government, on the issue of the hospital estate at Airedale.

Quite rightly and justifiably, my hon. Friend thanked the team there and I hope that he will allow me to join him in doing so. I ask him to pass on to them my thanks for everything they have done, not just during the past extraordinary 18 months, when they have been amazing, but year in and year out. They do so not only for his constituents but for those of the Minister of State, Department for Transport, my hon. Friend the Member for Pendle (Andrew Stephenson), my right hon. Friend the Member for Skipton and Ripon (Julian Smith), and of course my hon. Friend the Member for Shipley (Philip Davies). I know that all of them join with him in pressing the case for a rebuild of Airedale General Hospital.

In a sense, my hon. Friend the Member for Keighley is also putting his money where his mouth is, because, if I correctly recall my reading of Keighley News, one of the things that he is doing—he is certainly a braver, or at least fitter, man than I to do it—is running 100 km in, I think, 10 weeks, to raise money for a number of charities, including Friends of Airedale, which he rightly paid tribute to. I wish him all the very best with that.

As my hon. Friend alluded to, I had the pleasure of meeting him and other local MPs back in February to discuss this important matter; indeed, he and I have spoken about it on several occasions. Since his election to the House, he has never missed an opportunity to lobby me, very politely but firmly, and to raise this issue with the Secretary of State and I, on behalf of his constituents.

My hon. Friend set out the history of the hospital site and quite rightly highlighted the vital issue, which is the fact that reinforced autoclaved aerated concrete—the light form of concrete used primarily for roofs from the mid-1950s to the mid-1980s—is the key component part of these buildings. He also quite rightly highlighted the limited durability of RAAC roofs, saying that it has been long recognised but that recent experience suggests the problem may be more serious than previously appreciated.

My hon. Friend also highlighted in his comments that surveying is continuing at Airedale General Hospital to assess fully the extent and condition of the RAAC planks, and I believe that completion of that survey is expected in the coming months. I have asked to be updated when that full survey becomes available. However, I understand that preliminary survey findings have found issues relating to the deflection of rack panels, which I know caused his trust concern.

I fully recognise the need to invest in improving health infrastructure across the country. These safety risks are no different, and my hon. Friend emphasised the urgency of this. At the spending review 2020, courtesy of my right hon. Friend the Chancellor, we provided the NHS with £4.2 billion in 2021 for operational capital investment to allow hospitals to maintain and refurbish their infrastructure, including a £110 million ring-fenced allocation to address the most serious and immediate risks posed by RAAC planks. Within that ring-fenced allocation, as my hon. Friend mentioned, is a significant multimillion-pound allocation earmarked to mitigate RAAC risks at his local hospital. That will go towards re-roofing, as well as decant facilities while work is under way, helping to improve safety for patients and staff. We will continue to review business cases and progress at RAAC-affected trusts, including his, to ensure that we make the full and best use of all those funds over the coming year.

My hon. Friend highlights an important point: at what point does fixing or mitigating something cost more than actually eliminating the risk by having a modern, fit-for-purpose facility going forward? I fully recognise the need to mitigate RAAC risk beyond this year, alongside further investment in mitigation, which I have to confess will be a matter for my right hon Friends the Chief Secretary of the Treasury and Chancellor in the spending review. My hon. Friend would not expect me to pre-empt them, as that can sometimes have unfortunate consequences.

My hon. Friend will know, in that context, that RAAC remediation is not the only area we are investing in at Airedale, because of course on top of that the foundation trust received just shy of £250,000 to upgrade its emergency department from the wider package of £450 million for A&E improvements announced last year by the Prime Minister. Last year, the trust also received a £1.7 million allocation to address backlog maintenance at Airedale General Hospital from the £600-million critical infrastructure risk fund.

Of course, my hon. Friend wants me to speak about the future. He highlighted his strong campaign for investment in a new hospital for his constituents beyond the investment we are making to manage and mitigate the immediate risks. As he will be aware, the Prime Minister and the Health Secretary confirmed that 40 new hospitals will be built by 2030, with funding of £3.7 billion confirmed for the first tranche. I know my hon. Friend was disappointed that Airedale was not in that first tranche, but as is typical of him—ever undaunted—he continued his campaign to persuade the Government with ever-renewed vigour. I can offer him some hope on that, in terms of the prospects for the eight hospitals to which he referred.

An open process will be run to identify those eight further new schemes, delivering on the Government’s manifesto commitment. He asked a couple of specific questions about those, which I will endeavour, in so far as I can, to answer now. The details of this, the criteria and how that process will be run are due to be announced soon, with a generous period for trusts and sustainability and transformation plan and integrated care system partners to respond. To put a little bit more colour on that, I hope that we will be able to make that announcement of the process before the summer recess. I will of course keep him fully aware of progress on that.

My hon. Friend also asked about funding and how it might be allocated. Again, with the caveat that I cannot pre-empt any spending review announcement and the Chancellor’s decision on that, I would not anticipate that all eight of those would be ring-fenced for hospitals such as his. However, I would say, which I think will encourage him, that clearly one of the key criteria and considerations in the allocation of whatever funding is made available will have to be safety considerations and the urgency of any need for a new hospital. That will not be the only factor, but I reassure him that the Secretary of State and I will bear that very much in mind. I also reassure him that any trusts that receive and spend money in the interim to mitigate safety issues will not find that having undertaken that work will in any way count against them in a bid for a new hospital. It will be fairly and openly considered. I am sure the points he has made will be reflected in that.

We continue to work closely with trusts and regions to ensure that the criteria for selection best meets the needs of the NHS both nationally and locally and, of course, achieves value for money for the taxpayer. In that context, those schemes that we will consider will be based on the balance of benefits realised for staff, patients and local communities, condition—going to the safety point—and affordability and value for money.

As part of a national programme, seeking to achieve value for money, we will look for a greater degree of standardisation across those new hospitals, with modern methods of construction and modular builds, where appropriate. I note my hon. Friend’s points and, should we get to that point, I suspect he will want to be engaged in the discussions to ensure we get value for money. Were his hospital to get the go-ahead, it would also deliver what is needed locally. As my hon. Friend touched on in his speech, we are looking for new hospitals to be digitally fit for the future, clean, green and sustainable.

I suspect my hon. Friend will continue, until I, the Secretary of State or the Chancellor relent, to make the firm case for Airedale’s inclusion in our hospital building programme of those next eight. I very much look forward to seeing the bids for the remaining slots when the time comes for them to be submitted. I suspect, though I cannot pre-empt it, that his hospital might be one of those bids that I see put forward by the trusts.

In conclusion, as ever I want to commend my hon. Friend’s work to raise support for Airedale hospital, and personally raise money for the friends of the hospital. On numerous occasions in this House, he has raised the estate issues faced by his hospital. We are taking action in the short term to help mitigate those risks, but he continues to make the case for the long term. His constituents are incredibly lucky to have a Member of Parliament who is so assiduous and determined in carrying out his role in representing them to Government and in this place.

He kindly invited me to sunny Airedale—hopefully sunny, if I go in summer—to visit the hospital and the trust, and I would be delighted to take him up on that. He may face the challenge, given my risk of vertigo, of getting me up on the roof, though I suspect that will not deter him from trying to persuade me to see the issues for myself. I am happy to come and visit him and other right hon. and hon. Friends in the area.

More broadly, I look forward to continuing to work closely with him; my right hon. Friend the Member for Skipton and Ripon; the Minister of State, Department for Transport, my hon. Friend the Member for Pendle; and my hon. Friend the Member for Shipley, in seeking to deliver on the Government’s ambition of levelling up and improving the NHS services available across the country to our constituents.

Question put and agreed to.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 8th June 2021 Commons Chamber

[Chris Loder (West Dorset) (Con)]

What steps he is taking to support the construction of a new psychiatric intensive care unit in Dorset.

[The Minister for Health (Edward Argar)]

I am grateful to my hon. Friend, not least for providing me with my only opportunity to answer a question on the Order Paper today. I am delighted to confirm that St Ann’s Hospital in Dorset is already part of our plan to build 48 hospitals by 2030—the biggest hospital building programme in a generation. The new build at St Ann’s will provide child and adult mental health services for the people of Dorset, resulting in outdated infrastructure being replaced by facilities for staff and patients that are at the cutting edge of modern technology, innovation and sustainability, driving excellence in this hugely important area of patient care.

[Chris Loder]

I thank the Minister for his hard work in reopening the Yeatman Hospital in Sherborne, which will happen in a couple of weeks for A&E. On top of what he has already offered, which I very much appreciate, will he commit specifically to increase inpatient provision for children and young people in West Dorset with severe mental health difficulties, as we have a number of difficult cases?

[Edward Argar]

My hon. Friend takes a great interest in these matters and, as he will know, the number of places commissioned is a matter for NHS commissioners locally. I reassure him that we can commit, and my hon. Friend the Minister for mental health services is committed, to expanding and transforming community mental health services across England, boosted by an additional £79 million this year, so that children and young people get timely access to the support and treatment they need, without having to be admitted to hospital. That is, of course, alongside the investment to which I have referred for inpatient mental health facilities at St Ann’s.

[Ian Levy (Blyth Valley) (Con)]

What steps his Department is taking to reform mental health treatment.

Kettering General Hospital

Edward Argar Excerpts

Tuesday 8th June 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

I congratulate my hon. Friend the Member for Kettering (Mr Hollobone) on securing this debate about the redevelopment of Kettering General Hospital. I know that it is an incredibly important subject for his constituents and, therefore, for him. He is nothing if not a strong champion for the people of Kettering, as Ministers forget to their cost. He works tirelessly on not only this but many other local matters.

I should also highlight the interest in and passion for this subject of my hon. Friend the Member for Wellingborough (Mr Bone)—who remains a friend, despite him seeking to slightly pre-empt and constrain me today by asking a question of my boss, the Secretary of State, a few hours ago in the Chamber—and my hon. Friend the Member for Corby (Tom Pursglove). As my hon. Friend the Member for Wellingborough rightly said, due to his elevated position as a senior Government Whip, my hon. Friend the Member for Corby is unable to speak in the debate, but I know from the interactions and conversations I have had with him on many occasions just how passionate he is about this hospital project on behalf of his constituents. I can reassure his constituents that, while he may not be speaking in the debate, I have had many lengthy discussions with him, and I suspect that I will be hearing from him many times in the future—although, hopefully, if I can offer some reassurance to my hon. Friend the Member for Kettering, he may be slightly less vociferous in pursuing me on this matter.

I join my hon. Friend the Member for Kettering in paying tribute to the chief executive and the team at Kettering General Hospital for the amazing work they do. They have worked tirelessly throughout this pandemic for his constituents and those of my hon. Friend the Member for Corby, as they do day in, day out, year in, year out for the people who live in that area. It has been a pleasure to take a very close interest in this matter. As my hon. Friend the Member for Kettering knows through his experience in the House, it is sometimes very difficult to say no to him, which can get Ministers into trouble; he is extremely persuasive.

Turning to the substance of the debate, I am delighted that the rebuild of the Kettering General Hospital part of the foundation trust is part of our plans to build 48 new hospitals by 2030—the biggest hospital building programme in a generation. To kick-start the scheme, Kettering General Hospital NHS Foundation Trust has already received £3.7 million of seed funding to develop its plans for the rebuilding of Kettering General Hospital.

Before I turn to the urgent care hub, my hon. Friend the Member for Wellingborough highlighted that plans for that had been mooted, discussed and possibly even agreed before 2015—before my hon. Friend the Member for Corby and I joined this House. The difference, I would suggest, is that on that occasion there was no budget allocated to the trust. For the urgent care hub, there is a budget allocated to it now, following our announcement in 2019, which followed lobbying by my hon. Friend the Member for Kettering. That funding will help transform the provision of urgent and critical care in this area. As he says, £46 million has been allocated for that project.

My hon. Friend asks why it is that, 20 months on since that debate and that visit—I remember them well and I will turn to them in a moment—the money has not been fully drawn down. This is in no way a criticism, but I would say that that is because of the announcement of the new hospital programme and the fact that the trust has, quite rightly, changed what it would like as a result. Therefore, discussions have had to take place about how those two funding streams can be meshed together. I will turn to that in a moment.

As my hon. Friend mentioned, the urgent care hub and the new hospital that are to be built share a set of common enabling works that have been factored into the new hospital development. As he and his trust have requested, we have shown flexibility and agreed to mesh the two projects together if an appropriate way of doing so, including the funding, can be found. As a result, the trust is seeking to incorporate the urgent care hub delivery into the wider redevelopment of the site. That means that the UCH may now be part of the first stage of building the new hospital, but he rightly highlights how approaching this in a more holistic way than a “phase 1 and 2” approach provides opportunities and synergies for achieving better value for money. He has made that point to me and to others.

On the drawdown of funding, the £46 million is available, subject to business case approvals and how those two funding streams can be meshed together in a single project. On drawing down from the new hospital programme fund more broadly, we have a one-year spending settlement from the Treasury. Therefore, if we wish to start drawing down from future years funding and make commitments, that is a matter for the Treasury and a future spending review. My hon. Friend quite rightly highlights, as I expected he would, the need for a synergistic approach between the Department of Health and Social Care and Her Majesty’s Treasury.

All of the new hospitals that will be delivered as part of the programme, including Kettering, are working with the central programme team, with the support of regional, system and local trust leaderships, to design and deliver their hospital in keeping with this approach. The central programme team and the new senior responsible officer, Natalie Forrest, who joined the team and took over its leadership at the beginning of this year, are working closely with the trust on the new build at Kettering and considering all the options currently on the table. I understand that they have had productive meetings, and I look forward to their having further productive meetings.

The programmatic approach will need to be carefully applied to these proposals, as for any other hospital in the new hospital programme, to see how we can best ensure value for money for the taxpayer through standardisation of design and the use of modern methods of construction, without unnecessarily constraining the ambitions of the trust’s plans, in so far as that is possible. The central team, as I have said, will engage with trusts to maximise the application of these approaches to ensure that the scheme has manageable, realistic and, indeed, affordable costs. Funding discussions for these projects are ongoing, and final amounts will be determined through the established business case and Treasury processes.

To stray slightly from the central theme, as my hon. Friend will know—as, indeed, he said in his remarks—Kettering General Hospital NHS Foundation Trust also received £1 million pounds as part of the £450 million investment to help upgrade A&Es and to help the NHS respond to winter pressures and the risks of further outbreaks of coronavirus. That funding was used to support compliance with social distancing and infection prevention and control at Kettering.

On interactions and conversations with the trust, as I have alluded to, the senior responsible officer, Natalie Forrest, met the trust on 2 March for a bilateral roundtable with its senior leadership team to discuss its proposed plans for the build. I understand that those discussions were productive, and they are ongoing. I, too, met the trust in February, with the SRO, to discuss the plans for a new build at Kettering General Hospital. As my hon. Friend mentions, I was fortunate enough to visit the hospital in September 2019 to see for myself, and to be shown by him at his most persuasive, what the case for investment was. As he mentioned, I also had the pleasure of answering a Westminster Hall debate last October on the need for the urgent care hub being funded and built in Kettering, during which I also had the pleasure of confirming the funding, following on from the announcement and promise made by my right hon. Friend the Prime Minister to my hon. Friend. Today’s debate is probably not the right time to discuss this, but I know that all three of my hon. Friends have highlighted the wider opportunities of combining health and social care for vulnerable adults in Northamptonshire.

Our ambitious programme to build 40 new hospitals by 2030 has confirmed funding of £3.7 billion at this point. That is an important and extremely positive start, but we continue to work with Her Majesty’s Treasury on future funding for the whole programme, including for Kettering, and the profiling of the availability of that funding. That is not the reason I am not, at this Dispatch Box, being gently lured by my hon. Friend into a clear commitment today on firm profiling of financial allocations for Kettering at this stage; rather, it is because deciding the funding level for a project of this scale, at this early stage in the process, before full design, exploration or scoping is complete, would not be the most appropriate approach, although I take his point about, for want of a better way of putting it, the need for speed.

Our experience of Government projects and, specifically, the lessons learned from the early work of the Chancellor’s Project Speed taskforce and from the experts in the Government’s Infrastructure and Projects Authority tell us that confirming funding for large, complex projects too early, before all parties are fully agreed on the future approach, can put the project and its overall cost at risk. I am not in any way questioning the ability of my hon. Friend’s local hospital trust to come up with a costed and extremely effective project plan, but it is important, as he would expect, that we are conscious of the need to ensure that we get value for money and the best outcomes for his constituents.

In conclusion, I pay tribute to my hon. Friend, and to my hon. Friends the Members for Wellingborough and for Corby, for the work they are doing to support the redevelopment of Kettering General Hospital. I know that my right hon. Friend the Secretary of State gave the commitment to my hon. Friend the Member for Wellingborough that he would meet him, and I know that he will honour that. I reiterate my commitment that if any point, on perhaps at a more detailed or granular level, my hon. Friend the Member for Kettering wishes to meet me or the SRO again, I am happy to do that. Perhaps as we see progress made in opening up our country again, I might be able to enjoy the pleasure of returning to Kettering to see him and his hospital trust in person. I look forward to continuing to work with him to making sure that this ambitious and innovative approach to building new hospitals is a success.

My hon. Friend is, rightly, incredibly proud of his team in Kettering. He and his colleagues have done a fantastic job of gently inducting me into quite how fantastic the team are and what is needed to get this project going. It was one of the first visits I made when I became a Minister holding this role, so I have a particular affection for that area—I am an east midlands MP, so I know it well. I hope that we will continue to be able to work hand in hand with his trust, the national programme and Her Majesty’s Treasury to move this programme forward at pace. I know it is what he wants, but most importantly I know it is what his constituents would want and expect of us.

Question put and agreed to.

A Plan for the NHS and Social Care

Edward Argar Excerpts

Wednesday 19th May 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

I start by welcoming the right hon. Member for Ashton-under-Lyne (Angela Rayner) to her new post, and I wish her well in it. I apologise to her that she is facing me giving the wind-up rather than the Chancellor of the Duchy of Lancaster or the Paymaster General. However, given her encounter with the Paymaster General yesterday, she might be quite grateful for that.

Since the previous Queen’s speech in January 2020 we have all collectively been engaged in responding to the biggest crisis since the war, fighting a highly infectious and highly dangerous virus that has caused so much disruption to our economy and our society. Everyone has made huge sacrifices to get this virus under control, and I would like, as I often do on these occasions, to once again put on record my thanks to everyone in the NHS and social care, and the entire British people, for the massive part that everyone has played in that effort.

We now have a way out, thanks to the vaccination programme that is making this country safer every day, and I pay tribute to the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), for his work on that; but we all recognise that alongside that successful vaccination programme we must all, as a society, learn to live with residual elements of covid for some time to come. My right hon. Friend the Health Secretary’s vaccination programme has been the biggest and fastest in British history. Around seven in 10 adults have had a first dose, including my right hon. Friend and me—I resisted any temptation to do so without my top on—and around four in 10 have had a second. As we have rolled out the programme, we have been able carefully to remove some of the restrictions that have been so difficult for us all. Even this week we have been able to restore more of those precious moments, like meeting friends and family indoors or having a pint inside a pub once again. As we do that and take the road to recovery, we must take forward what we have learned about all parts of our health and care system, and draw on the spirit and endeavour that we have seen in our vaccination programme and so many other parts of our response, to make the lasting reforms that will allow us to build back better and make us a healthier nation. There is still a lot to do and there is no time to stand still.

This Queen’s Speech sets out an ambitious, positive programme to seize that opportunity. As my right hon. Friend the Health Secretary set out, we need to tackle waiting lists through our catch-up and recovery plan to support the, I believe, 4.7 million people in England—around February—waiting for treatment. We need to continue to deliver our manifesto commitments of 40 new hospitals and 50,000 more nurses. And we need to level up on the health inequalities that the pandemic has laid bare. To meet that challenge, we have an agenda to transform our health and care system, and to give us those firm foundations that we need to thrive in the years ahead.

We have set out our plans for our health and care Bill to enable greater integration—I saw, in my years serving as a local councillor, as I suspect many colleagues in the House have, the benefits of the NHS, local authorities and social care working ever more closely—to reduce bureaucracy, and to strengthen accountability to this House, so that we can allow staff to get on with their jobs and provide the best possible treatment and care for their patients, and give the NHS and local authorities the tools they need to level up health and care across the country.

We will also give the funding and support to help our NHS recover and deliver the care that people need, bringing the total package of additional covid-19 funding to our healthcare system to £92 billion—on top of the legislation that my right hon. Friend the Health Secretary and I passed last year, which will see funding in our NHS increase by £33.9 billion by 2024.

The virus has attacked many parts of our society and our healthcare system. Before returning to some of the key themes in the health space and the care space, I want to mention some of the contributions to the debate. My hon. Friend the Member for North West Norfolk (James Wild) highlighted the importance of knowing what the bidding criteria will be for the extra eight hospitals that we have committed to bring forward. I know, Madam Deputy Speaker, that you and my hon. Friend the Member for Don Valley (Nick Fletcher) came to see me earlier this week to talk about your proposals for Doncaster hospitals. We recognise the eagerness of colleagues to know what that procedure will be, and we will be bringing that forward in the coming weeks. I highlight, of course, that that is dependent on the spending review as well.

Let me turn now to the shadow Secretary of State and some of the points that he raised, which I will endeavour to address. He is a good man, and I know that he will still be basking in the joy of Leicester City’s success on Saturday. He raised some important points. First, he asked where diagnostics were in all of this. I remind him that, in 2019, we brought forward £200 million of additional funding to provide around 300 new diagnostics machines, which have already been bought for our NHS, and we have set out plans for the future for 44 diagnostic hubs.

The right hon. Gentleman talked about capital spending. A total of £3.7 billion in the first tranche has been allocated for our 40 new hospital programmes. He will know, because his constituency neighbours mine, that he is one of the beneficiaries of that, with a new hospital in Leicester. I also point out to the shadow Chancellor of the Duchy of Lancaster that Tameside General Hospital has benefited from considerable capital investment —£16.3 million in 2019 thanks to this Conservative Government and, atop that, there is the £450 million of extra money that we brought forward for urgent and emergency care last year, of which around another £2 million is going to Tameside and Glossop Integrated Care NHS Foundation Trust. This is a record of investment by this Government in communities up and down our country.

The shadow Secretary of State was pressed a couple of times by my hon. Friend the Member for South Suffolk (James Cartlidge) on whether he supported the use of private sector hospital facilities to help get those waiting lists down. He dodged answering that question. I know that he is a sensible and pragmatic chap, and I know that he will recognise the need, as we do, to use every resource at our disposal to get those waiting list down. I hope that he will not give in to the siren voices of some on the Opposition Benches who, in their comments, have highlighted what I think is a real issue for the Opposition. I am talking about this sort of Orwellian “Animal Farm” type tendency: four legs good, two legs bad; public sector good, private sector bad. It is a binary approach. The reality that we have seen throughout this pandemic is that the key has been partnership working: public, private, and voluntary sectors working together, putting ideology aside to get the best outcomes for patients. All I say is that those who advocate a binary approach are actually letting down our public services. [Interruption.] The right hon. Member for Leicester South is getting a new hospital.

Let me move on now to other contributions. I turn to the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) and my hon. Friend the Member for Aberconwy (Robin Millar), both of whom gave eloquent, accomplished speeches. I wish that I had been as eloquent in my maiden speech. They are clearly strong advocates for their constituents. I sincerely hope—indeed, I am sure—that we will rightly hear a lot more from them in the future, and that is all to the good of our democracy.

I want to pick up on a couple of other contributions. The hon. Member for Rhondda (Chris Bryant), who is a strong champion of the cause of those with acquired brain injuries and brain injuries, and my hon. Friend the Member for North Dorset (Simon Hoare) came to see me relatively recently to talk about the importance of that group of people in our resetting of NHS services and our recovery of waiting lists. Not only do I pay tribute to the hon. Gentleman, but I am always happy to meet him to further discuss those issues if he feels that I can be of any assistance.

Turning to some of the key themes of the Queen’s Speech particularly in the health space, the virus, as many hon. and right hon. Members have highlighted, has attacked our population’s mental health just as much as our physical health. On top of the record funding we have already given to mental health—an extra £2.3 billion a year for mental health services by 2023-24, plus the £500 million of additional investment that my hon. Friend the Minister for Patient Safety, Suicide Prevention and Mental Health announced recently—we are determined to address the impact of the pandemic on mental health and wellbeing. I know that that objective and that desire, whatever the party politics that sometimes occurs in this Chamber, will be shared across both sides of this House. While we will rightly be held to account, I hope that we can all move forward in seeking to improve services in that space together. I also hope that we will be able to work together in reforming the Mental Health Act 1983, which, as my right hon. Friend the Secretary of State said, has not been fully updated for nearly 40 years, and in so doing, give people greater control over their treatment and ensure dignity and respect.

As Members have highlighted, there is also more to do so that everyone receives high-quality, joined-up care in our social care system. The Prime Minister and my right hon. Friend have been absolutely clear in their determination that we will bring forward our proposals for reform of social care this year so that everyone receives the dignified care they deserve within a system that is sustainable. While I hope we can move forward together, I will take no lessons from Labour, which, in its time in power, had, in seeking to address this, one royal commission, two Green Papers, and a spending review in 2007 at which it said that it would be the main focus. That is 13 years of consultations and no achievement. I hesitate to draw attention to it, but some of those years would of course be years when the right hon. Member for Leicester South was at the heart of government in the Treasury and in No. 10.

As we do this work, we will be drawing on the considerable strengths that have played a starring role in this pandemic—the technology, the research, and the life sciences so beloved of my right hon. Friend the Secretary of State—to drive innovation in our NHS and social care to make life easier for patients and staff alike and to help us all live healthier and happier lives. In that vein, we will, for example, increase public spending on research and development to £22 billion.

It is an honour to make the final contribution to this Queen’s Speech debate on behalf of the Government. We have seen before us a stark choice between a Government with a clear, ambitious vision for our country and its health and an Opposition yet again devoid of ideas, tired and lacking in energy, whose only solution is yet another policy review. That has been the response to the damning verdict of the electorate when they said they were fed up with being taken for granted and let down by Labour. Over the past six days of debate, we have heard about this Government’s ambitious agenda to level up all parts of our country: an agenda to beat this virus and beat it together, and an agenda that will unleash the potential of the whole of the United Kingdom. I commend the Queen’s Speech to the House.

Question put, That the amendment be made.

Air Ambulance Funding

Edward Argar Excerpts

Monday 26th April 2021 Westminster Hall

[The Minister for Health (Edward Argar)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I thank the hon. Member for Linlithgow and East Falkirk (Martyn Day). As the shadow Minister, the hon. Member for Nottingham North (Alex Norris), said, when members of the Petitions Committee turn their hands to giving extremely well-informed and erudite speeches on whatever topics come through the Committee, they display a certain dexterity. I pay tribute to the hon. Member for Linlithgow and East Falkirk for his thoughtful speech, as ever, and to my hon. Friend the Member for Wakefield (Imran Ahmad Khan) and the shadow Minister, who made typically measured, sensible and thoughtful contributions to this important debate. Although what goes on in the main Chamber may attract more public attention, I often think that if more people were aware of what goes on in this Chamber, they would find that the tone of many debates is different from the one at the Dispatch Box in the Chamber, and that there is a genuinely constructive exchange of views.

As the shadow Minister said, to date more than 130,000 people have signed this petition, and I thank them all for highlighting this important issue for debate. Like him, I pay particular tribute to Bethany for her work in getting such a huge number of signatures for this petition and echo the words of other hon. Members in sending our sympathies to her family. If I may slightly crave your indulgence, Mr Stringer, although this is not directly related to air ambulances, I will take this opportunity —I suspect it may be the only chance I have to do so before Prorogation—to put on the record the condolences and sympathies of all in the House to the family and friends of ambulance technician Jeremy Daw, who was tragically killed at the weekend when on duty when his ambulance was hit by an object. It is important to put on the record our sympathies and condolences to his family and friends.

I pay tribute, as others have done, to the air ambulance charities and to their critical care teams of doctors and paramedics, who are among some of the most highly skilled pre-hospital clinicians in the world. They are capable of performing life-saving hospital-level procedures on patients at the roadside and saving lives. That includes administering general anaesthetic and, indeed, open heart surgery. When a life-threatening injury or medical emergency happens, patients need to be transferred to hospital as quickly as possible. In some cases, survival can depend entirely upon the vital life-saving work of the UK’s air ambulance charities. Air Ambulances UK figures show that, on average, air ambulance charities across the UK collectively complete more than 25,000 of these life-saving missions a year. To put that another way, as the shadow Minister did, every 10 minutes an air ambulance helicopter takes off somewhere to attend an accident or medical trauma.

Last year, I had the huge privilege of visiting the amazing charity London’s Air Ambulance. I saw at first hand the amazing work of the crew who undertake their life-saving missions day in and day out, working alongside the staff of the Royal London Hospital and the London ambulance service to care for the most critically ill patients. I pay tribute to the team there who showed me around—their comms team includes a former member of a member of my staff who now works there, Kirsty McKellar—for their forbearance as I displayed, shall we say, certain symptoms of vertigo while I climbed a ramp to the top of the hospital to see the helicopter on its pad.

The shadow Minister highlighted the cost of every take-off and every mission, so he will be reassured to hear that I did not avail myself of an opportunity to go up in the helicopter; that would not have been a good use of funds. However, I was able to talk to the team and to see their work at first hand. They were clear that they are incredibly proud of their charitable status and their work as a charity. They quite rightly raised a number of issues with me, one of which I will put on the record now: they ask that councils in London and those who have open spaces are always mindful of the need to try to keep those spaces accessible for London’s air ambulances so they can find somewhere to land in this busy city in which we stand today. I was incredibly grateful to the team not only for showing me around the air ambulance and showing me their procedures, but for their amazing work day in and day out. Indeed, I put on the record my gratitude to all the air ambulance charities.

We recognise that air ambulances provide an invaluable service to our NHS. They support the NHS emergency response on the ground and ensure patients get specialised care in both urban settings and hard-to-reach rural areas. Air ambulances also provide additional support to on-road ambulances at times of high demand through the use of critical care cars to increase capacity and ease pressures on NHS services. Additionally, air ambulance services have supported the national covid-19 response by using their aircraft to transfer patients, doctors and equipment, including medical supplies, between hospitals.

I turn now to the heart of the petition and the debate. Although air ambulances provide services to the NHS, it is right that they are not directly funded by the NHS, and that the majority of their resources are drawn from their fundraising activities. That is something that the air ambulance charities support, as hon. Members, particularly my hon. Friend the Member for Wakefield, have alluded to. As the hon. Member for Linlithgow and East Falkirk set out, it is not about the predictability or certainty of Government funding; there are other things that make the charities support the current model. For example, Anna Perry, the chief executive of the Great Western Air Ambulance Charity, said, “In terms of funding and our day-to-day costs, we value the independence our charitable funding provides us. If we identify that our patients need a different kind of treatment or approach, then we can be responsive to those needs. We cover a diverse area, from the Forest of Dean to Cirencester, and from Bath to Weston-super-Mare, and our funding means we remain flexible and innovative in responding to what our communities need from our life-saving service.”

Similarly, the chief exec of the Lincolnshire and Nottinghamshire Air Ambulance said, “While there are benefits to being Government-funded, as an independent, highly regulated charity, we greatly value the ability to be flexible to the changing needs of our patients—for example, by having the ability to quickly adapt to new technologies and medicines. The Lincolnshire and Nottinghamshire Air Ambulance”—I believe it covers the constituency of the hon. Member for Nottingham North—“is very much a part of the communities we serve. We are funded by them and are accountable to them.”

I will share a final quote to emphasise the view from the charities. Amanda McLean, who is the chief executive of Thames Valley Air Ambulance, said, “Operating within a charitable model allows air ambulance charities up and down the country to provide efficient, responsive and tailored care to best meet the needs of their communities. By working independently, embedded within our local areas, we are able to collaborate and share best practice while offering a service that is targeted to meet the specific challenges we each face.”

Those are a few examples, and hon. Members have given similar examples from different chief executives of different charities. As the shadow Minister said, it is important that we listen to what the charities that run the air ambulances are telling us.

As has been alluded to, that is not to say that the Government do not provide significant support to the sector. In 2019, the Department of Health and Social Care launched a three-year capital grant programme, which allocated £10 million to nine air ambulance charities across England. These capital schemes provide a range of new equipment and upgrades to support air ambulance services to move towards 24/7 operations, allowing more patients in need of an emergency response to be reached. The funding will also support the modernisation of facilities at seven air bases across England, including building interactive training suites to better prepare crews for challenging conditions, with the addition of seven new critical care cars and a new helicopter.

As hon. Members have mentioned, last year the Government announced a further £6 million of covid-19 emergency funding for Air Ambulances UK to distribute to the air ambulance charities in order to ensure that each charity could continue to provide its life-saving services during the pandemic. Like the shadow Minister and hon. Members who have spoken, I believe that was the right thing to do, as the charitable fundraising activities that they would normally undertake were clearly impacted on by the constraints imposed by the pandemic and the restrictions that were necessary to tackle it. Of course, we support air ambulances through close collaboration with the NHS. For example, NHS ambulance services commonly provide key clinical staff and medical equipment to support air ambulance operations.

Given how vital such services are, it is not surprising that our electors—the public—are keen to see them funded by the Government as part of the NHS. Having listened to the sector, however, our view remains that the charitable model for air ambulances remains the right one—a view that, as I say, is shared by the sector’s independent professional body, Air Ambulances UK. That model has been a long-standing success; London’s Air Ambulance was established as a charity as far back as 1989, and I believe it has now helped more than 40,000 patients.

Decisions on the provision of services for the safe delivery of care are best made at local level. Maintaining a charitable model gives charities and the air ambulance the independence they need, as I alluded to in the earlier quotes, to deliver specialised services tailored to the needs of patients in each locality. A charitable model is also, in many ways, a more feasible way to fund the high capital and revenue costs associated with helicopter emergency medical services, including purchasing and maintaining helicopters. It also gives charities the independence to raise funds through commercial activity and sponsorship with their commercial partners.

Before the pandemic struck, I had the privilege of visiting and—for a brief period—helping in the Birstall air ambulance shop in my constituency, which supports the Derbyshire, Leicestershire and Rutland Air Ambulance service. It would be remiss of me not to take the opportunity to put on record my gratitude to it, as my local air ambulance service, for the amazing work it does, day in and day out, across that part of the east midlands. Indeed, even during the pandemic last year, two new helicopters were delivered to help to support that service. I believe it is the only air ambulance service that delivers a children’s air ambulance service. Let me put on record my gratitude for and recognition of the amazing work it does.

I believe, and the charities believe, that the current model still represents the best route to funding our air ambulances—those cherished institutions—because it gives them local flexibility to do what they need to do. In future, we want to build on the success of air ambulance services and their contribution to the delivery of safe and effective care to the nation. As part of transforming how urgent and emergency care operates, NHS England and NHS Improvement have been working with ambulance services on new ways to deliver care to patients. For example, rather than conveying all patients to hospitals, ambulance services are developing new ways to give healthcare advice through video consultations and by referring patients to a greater number of services in primary care in the community. As we move to a new model of integrated care, each system will have the duty to collaborate with health and care organisations in their local area, including considering how air ambulances can best contribute to their network of urgent and emergency care services.

Essential public donations combined with significant funding contributions from Government—be it for capital or in extremis, as we saw during the covid pandemic—will ensure that the air ambulance charities can continue to provide their world-class care for a patient-centred approach that works for the population they serve. Both the Government and Air Ambulances UK strongly believe that that is best achieved through a charitable model. I encourage everyone to support their local air ambulance charities, even if I do not give in to the gentle temptation offered by the shadow Minister to run the London marathon.

During these unprecedented times, I reiterate my unreserved thanks, and the thanks of all hon. Members who spoke and from across the House, to the staff at the air ambulance charities for continuing to provide their world-leading, life-saving care to patients and their local communities across the UK. They are genuinely inspirational to us all. There is a reason why so many people donate so generously to their air ambulance charities: they know that one day, they could be the one who needs that air ambulance. I suspect that across the country, there is the same huge admiration and gratitude for the fantastic work that these charities do every day.

Elective Surgical Operations: Waiting Lists

Edward Argar Excerpts

Tuesday 20th April 2021 Westminster Hall

[The Minister for Health (Edward Argar)]

It is a pleasure, as always, to serve under your chairmanship, Ms McVey.

May I start, as other hon. Members have done, by congratulating the hon. Member for Bootle (Peter Dowd) on securing the debate on this hugely important subject? As colleagues have said, this subject is so important not just to hon. Members, but to all our constituents. Given its importance, I suspect that it will not be in 12 months’ time that we next debate it. I would hope that, in the coming weeks and months, we will continue to debate the progress on reducing waiting lists and getting waiting times down, because that is important. I pay tribute to the hon. Gentleman’s typically reasonable and measured tone. I know that he takes a close interest in these matters, working with the all-party parliamentary heath group. If it is helpful to him, I am happy to meet him outside the Chamber to have further discussions about exactly what he said.

I of course join hon. Members in paying tribute to the amazing work of all those who work in our NHS. Once again, I thank them for their tireless efforts throughout the pandemic. Like other hon. Members, I make no apology for reiterating those thanks every time I have the opportunity to do so.

As the hon. Gentleman set out, and as the House will know, our goal throughout the pandemic has been to protect the NHS and save lives. At the peak of the pandemic, we focused on caring for covid-19 patients, while seeking to continue to prioritise urgent treatments such as surgery for cancer and other life-saving operations. The temporary pauses in other elective activity, and the reduction in the volume of such activity, were put in place to limit the number of patients and to help prevent the NHS from being overwhelmed, as well as for infection control. We have to be very clear, however, as hon. Members have been, about the impact that that necessary action has had on many tens of thousands of our constituents. All hon. Members have alluded to the fact that their constituents have suffered not just pain, but anxiety, nervousness and the impact that such delays can have on mental health.

By the summer of 2020, the NHS had started to recover elective activity after the first wave. Having learned from the first wave, it was able to keep elective activity going at a higher level, albeit not as high as some might have wished, through the second and subsequent waves. The situation is looking better for our NHS: there has been a huge fall in hospitalisations and deaths from covid-19, as the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), alluded to in his remarks, and the success of our vaccination programme means that more people now have longer-term protection from the virus.

Once again, the NHS has done incredible work in keeping as many services as possible going at a time of unprecedented strain. Despite the pressure of the pandemic, by December 2020, the NHS has recovered to carrying out nearly 80% of elective treatments compared with the previous year’s figures. As we continue on our journey to recovery, we must focus on addressing the pressures beyond covid that have been caused by the pandemic. To do that, we are providing the funding, the support for staff and the legal foundations to help our NHS build back better.

We as a Government, in partnership with the NHS, have turned our focus to recovering the activity that was lost following those necessary reductions in activity and, in some cases, the halting of elective treatments. As part of that, we encourage the public to please come forward, through campaigns such as “Help Us, Help You”, and to contact their GP if they are worried about symptoms, especially if they are potential cancer symptoms. The hon. Member for Bootle was absolutely right to highlight that this is not just about surgical procedures in an acute setting, but about the entire patient journey: getting people through the front door of their GP’s surgery; giving them a diagnosis or a provisional diagnosis on the phone, with diagnostic tests; and then the treatment that follows.

We know that waiting lists continue to grow for elective services, as all hon. Members have set out, with 4.7 million people currently waiting for treatment. Of course, we and the NHS are working incredibly hard to reduce that backlog. We will rightly continue to prioritise patients according to their medical needs as well as how long they have been waiting.

We have already seen promising recovery in services—the hon. Member for Ellesmere Port and Neston alluded to that—but it is also important that we recognise at this point, as hon. Members have done, the huge strain that staff and the NHS workforce have been under throughout this pandemic. As such, it is very important that in seeking to recover levels of activity, we do so in a way that enables those staff to have the time and space they need to recover physically and mentally from what they have been through.

I want to reassure hon. Members about the funding and the fact that there is a plan. That plan is being developed on the basis of evidence and pilots that we saw undertaken in London, for example, which I will turn to a moment. On 18 March, as part of the spending review, we announced a further £7 billion of funding for healthcare services. Over the next six months, the NHS will receive £6.6 billion to support that recovery. That comes on top of the funding increases that are already hard-baked into the NHS Funding Act 2020. At the last spending review, we announced an additional £1 billion investment to further kick-start recovery and begin addressing backlogs and tackling long waits. Looking at the shadow Minister, I reiterate from this Dispatch Box the words of the Prime Minister making it clear—very clear—that the NHS will have the resources and funding it needs to do the job.

As well as funding, we have been supporting the NHS to innovate because, as has been alluded to, funding alone is not the answer. We need to look at how we tackle the backlog, the care pathways and the approaches we adopt. That planning is already happening, working with the frontline. In elective surgery, the NHS is basing its approach on lessons learned from the London pilot programme that ran in October 2020 to redesign treatment pathways. Of course in that context I pay tribute to Professor Tim Briggs for his work on the Getting it Right First Time programme, which offers a huge opportunity to reform and improve the way we deliver care and those care pathways.

We have seen some great examples of innovation. I spoke to Tim Briggs this morning and he highlighted some of them, such as joint replacements and the impact that treatment can have on people. The Queen’s Hospital in Romford, the Nuffield Orthopaedic Centre in Oxford, the United Lincolnshire hospitals and the Royal Cornwall Hospital are all using innovative approaches to try to tackle that backlog. Croydon Elective Centre physically separated emergency and elective theatre units in what was the hospital’s blue zone, enabling it to run at 120% of pre-lockdown activity levels for routine procedures, including cancer, cardiac and hip operations. It is only one example, but it is an example of what the system is doing to innovate and try to get activity levels back to where we would like to see them.

During the pandemic last year, the out-patients programme avoided 18 million face-to-face appointments through the use of virtual appointments and reduced the number of unnecessary appointments, but I take the point made by the hon. Member for Bristol South (Karin Smyth) that there will always be some people or some people’s medical condition that will result in their wanting or needing to see a GP or a practitioner face to face.

On diagnosis, we are rolling out 44 community diagnostic hubs with the plan to deliver over 1 million additional scans and tests across CT, MRI, X-ray, ultrasound and ECGs. These are just examples, but these numbers are already helping the NHS to recover, and they have the potential to play a key part in the long-term approach to tackling waiting lists.

In the few minutes I have before the hon. Member for Bootle winds up, I will deal with some of the specific points he raised on behalf of the Royal College of Surgeons. On the first issue—urgently increasing bed capacity and critical care bed capacity—we continue to work with the NHS very closely to ensure we have sufficient beds to meet future demand, with hospitals flexing their bed capacity as required. It is important to note that one of the points Professor Briggs made to me is that the ability, with modern medicine and approaches, to tackle more elective procedures in day case surgery maximises the use of theatres and eases the pressure on beds. Where previously somebody might have been kept in overnight, the beds can be used for patients having procedures that require overnight stays.

The hon. Gentleman mentioned the consolidation of covid-light sites in every ICS region and talked about widening the adoption of the surgical hub model across all English regions. NHS England continues to design and refine the future operating models in the light of ongoing levels of community infection. The London region pilot has been looking at exactly that model and testing it. We have to make sure it does the job and delivers the results, as we want this to be an evidence-based recovery plan, but the early indications are promising. Using surgical hubs and separating out elective services through hot and cold sites are key components of the London region pilot.

A number of Members rightly said that we must not lose sight of health inequalities in our plan and our approach to tackling the waiting list backlog. We believe that the accelerated restoration of elective services and innovations in primary care will play a key part in improving local health outcomes and tackling health inequalities. That is an explicit part of what I am looking at as I draw up the plan with colleagues.

Finally, the hon. Gentleman talked about ensuring that all ICSs urgently consider what measures can be put in place to support patients facing long waits for surgery. We continue to work very closely on this. The hon. Member for Bristol South is right that many people who are communicating with patients are doing an extremely challenging and sensitive job, so it is absolutely right that we give them the support they need to know how to do it to the best of their ability, so that they, just as much as the patients, do not find it any more difficult than it inherently is. Local systems have been asked to plan their recovery as quickly as possible and in a way that supports those patients through their waits.

On statistics, the shadow Minister was kind to me. He raised a point of order a couple of weeks ago about statistics and over 52-week waits, but he did so very gently. When answering written questions, we are required to use published data, and at the moment it is not cut in the way that he wanted, which is fortnightly or weekly— 52 to 53, 53 to 54 and so on. He raises an important point, and I will write to him shortly to set out what we can do to increase the transparency with that level of granular data in the coming months. Again on a point made by the hon. Member for Bristol South, it is absolutely right that everyone can see what the challenge is at a local level, what approach is being taken to address it working in partnership with those local systems, and what progress is being made against the targets and the backlog.

In the 10 seconds or so that I have before I hand over to the hon. Member for Bootle, let me say that recovery of NHS elective services is one of the greatest challenges, but also one of the greatest opportunities that we have to transform patient care. We are completely committed to building the NHS back better, learning the lessons from the pandemic and doing all we can to ensure that patients—our constituents—receive the best possible treatment as quickly as possible, and that we reduce the waiting lists and waiting times.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 13th April 2021 Commons Chamber

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

What steps he is taking to ensure patients are consulted on the provision of their local health services.

[The Minister for Health (Edward Argar)]

The Government are committed to putting patients at the centre of our health service. Patients are consulted on their local health services in a wide variety of contexts, including through Healthwatch England, the independent national champion for patients. When a major or substantial reconfiguration or change to services is proposed, the local clinical commissioning group is legally required to hold a consultation with local people.

[Steve McCabe [V]]

I wrote to the Secretary of State for Health and Social Care about this issue a month ago. Last December, amid the pandemic, Birmingham and Solihull clinical commissioning group decided to close Goodrest Croft GP surgery—which has more than 6,000 patients—in my constituency. The CCG did not consult anyone because apparently it is not required to do so. Does the Minister find that acceptable?

[Edward Argar]

Although I am not familiar with the detail of the specific local case the hon. Gentleman raises, I am happy to meet him to discuss it if that is helpful to him.